Critical Decisions, ch. 9

by: Marty Chrisman

Luke made his way to the hospital cafeteria. He was hungry but nothing appealed to him. He settled for a cup of coffee and looked around the room for a place to sit. He saw Doc Applebee sitting at a table eating a sandwich. Walking over to his table, Luke said, “Hi, doc. Care if I join ya?”

“Of course not, Luke.” Doc said, looking up from his meal. “Have a seat.”

“Kelly’s not going to get better, is she?” Luke asked. No use beating around the bush. Luke needed to know.

Doc sighed, he hated having to give his patients or their families bad news, especially when they were old friends like the Dukes “I wish I could tell you that she was but I’d can’t. Right now, it’s the machines that are keeping her alive. We’re gonna be running some tests this afternoon and hopefully, they’ll tell us something more.”

“I wanna stay with her.” Luke said “Can you arrange that? I need to be with her, Doc.”

“I’ll take care of it.” Doc assured him. “I’m sorry, Luke. I really am.”

“Thanks.” Luke said, shoving himself to his feet and leaving is untouched coffee sitting on the table. “I appreciate you being honest.” Luke suddenly felt very very old. He knew that life wasn’t always fair, and sometimes bad things happened to good people, but this felt like getting kicked in the head by Maudine the mule.

When Luke went back upstairs he found that Bo had taken Daisy home since she had to work that night at the Boar’s Nest. Uncle Jesse was the only one in the waiting room. Luke slumped down on the sofa beside him. Jesse could tell that Luke was on the verge of total exhaustion. He hadn’t had a decent night’s sleep since the wedding. “Why don’t y’all stretch out and get some rest?” Jesse suggested, moving from the sofa to one of the chairs. He was prepared for an argument since Luke could be as stubborn as a mule sometimes. He was only mildly surprised when Luke did as he was told, stretching out on the sofa and throwing one arm up over his eyes. From the sound of Luke’s breathing, Jesse knew that he wasn’t asleep but at least he was resting for now.

“Jess,” Luke said in a barely audible voice

“Hmmm?” Jesse said

“She’s gonna die, isn’t she?” Luke asked, for the first time putting into words his greatest fear.

“I don’t know, son.” Jesse said quietly “The good lord’s the only one that knows that for sure.”

He saw Luke swallow hard as he struggled with the emotions that were raging inside of him. “I don’t want to lose her, Uncle Jesse. Not again.” Luke’s voice had taken on a ragged edge, betraying his inner pain.

“I know,” Jesse said softly, in a gentle voice. He moved closer to the sofa so that he could put a comforting hand on Luke’s shoulder. “But it’s not up to us. It never is.” He paused, choosing his words with care. “I wish I could make it easier for you, Luke, but I can’t. All I can do is be here if you need me. I love you, boy. You know that.”

Luke didn’t respond. He knew that he had the love of his family, no matter what and that had always been the most important thing in the world to the Dukes. But even their love and their support couldn’t help him now. He had to go through this alone. If Kelly died, Luke knew that his own survival and even his sanity would all depend on his own strength and will to live. And without Kelly, he just wasn’t sure how much he would have left of either one. Finally he dozed off for a little while.

After taking Daisy home, Bo returned to the hospital. He brought with him some of Daisy’s homemade beef stew that she had made especially for Luke. After some coaxing from Jesse, Luke finally managed to eat a few bites. Doc Applebee had stopped by on his way back from the cafeteria and told them that after the tests were done that they were going to do on Kelly, he would come back to let them know the results. All they could do was wait. Funny how everything bad about a hospital always seem to do with waiting.

It was late afternoon when Doc came back into the waiting room. From the look of his face, Luke knew the news wasn’t good. So did Jesse and Bo. Luke felt a sick feeling in the pit of his stomach as Doc ushered the three of them into an empty office next to the nurse’s station and closed the door. Doc gestured for them to sit down in the three chairs facing him as he sat down heavily behind the desk. He looked almost as exhausted as Luke did.

“We got the results back from most of the tests. We should get the results from the rest of the tests in the next couple of days.” He said in a weary voice

“They aren’t good are they?” Luke asked. He suddenly felt like his mouth was stuffed with cotton and he found it hard to take a deep breath. A band of steel had tightened around his chest making it almost impossible to breath.

Doc Applebee shook his head slowly from side to side. “No, I’m afraid they aren’t.” He took a deep breathe and looked at Jesse and Bo, signaling them with his eyes that Luke was going to need them more than ever within the next few minutes. He looked back at Luke, a young man that Doc had delivered as a baby. He hated this part of his job because he knew that he was about to destroy Luke’s life. “The tests we’ve done so far, indicate that Kelly isn’t going to get any better.” e paused to let his words sink in. He saw the pain that filled Luke’s blue eyes and he knew that what he had to say next would only add to that pain. “No matter what we do, she’s probably going to die. It’s just a matter of time.” Luke felt Jesse’s arm around his shoulders and Bo grabbed his hand, squeezing tightly.

“What exactly are you trying to tell us, Doc?” Jesse asked slowly, wanting to make sure they all understood perfectly what Doc was saying. “And keep it simple, none of them fancy medical terms that none of us understand.”

“She’s not breathing on her own, her pupils are fixed and dilated, and she’s not responding to painful stimulus.” He paused for several long seconds, and then he looked at Luke. “Those are all signs of an injury to the brain stem. The brain stem controls the  automatic functions of the brain, like breathing, controlling the blood pressure, our heart rate. That’s why Kelly is on the machines right now, her brain isn’t doing those things for her like it’s supposed to. If the brain stem has been damaged, then she’ll never be able to breath on her own again and she will’ll never come out of the coma.” Doc paused and took a deep breath before continuing. “As your doctor I have to ask you how you want us to proceed. By law, Luke is considered Kelly’s legal next of kin since they are married. I need to know if he wants us to turn off the machines and let her go.”

“No,” Luke said sharply, his eyes filling with pain as he realized just what Doc was asking him to do. He shook his head violently from side to side. “No, don’t ask me to do that.” Jesse arm tightened around Luke’s shoulders, trying to calm him down.

“It’s alright, Luke. Take it easy, nobody’s gonna make you do something you don’t want to do.” Jesse looked at Doc “Are they, Doc?’

“No, we can’t turn off the machines without Luke’s permission. I’m just giving you that option based on the preliminary tests and the seriousness of Kelly’s injuries.”

“What if Luke doesn’t agree to let you turn off the machines?” Bo asked in a carefully controlled voice, voicing the question that Luke was too upset to ask for himself.

“Then she’ll probably still die. It could take months, maybe even years. And she’ll stay just like she is now. There won’t be any improvement.” Doc took a deep breath and exhaled slowly “I can give you a couple of days to decide what you want to do. If you don’t turn off the machines, eventually she would have to be moved to a long term care facility where she could be given twenty-four hour care for however long she had left. And it would be very expensive.”

“Thank you, Doc. We’ll let you know what Luke decides.” Jesse said, helping Luke to his feet and leading him out of the room as if he were a child. Jesse had never considered this possibly, none of them had. He didn’t know how to advise Luke on this because Jesse didn’t know what he would do himself if he had to make the same decision involving one of his kids.

Back in the waiting room, Luke slumped down on the sofa and stared at the wall, his eyes unfocused and vacant. Jesse knew that Luke was going to need time to fully understand what Doc had said and to make the decision that only he could make. As long as there was even a glimmer of hope, Luke could go on but now that it looked as if that bit of hope had been taken away from him, he had to face a decision that would not only change his life forever but end Kelly’s life. A death that he would hold himself at least partially responsible for if he gave his consent to turn off the machines.

Luke looked at Jesse, his eyes clouded with unspoken pain and said softly “I can’t do it, Jesse. I can’t tell them that it’s okay to pull the plug.”

“I understand.” Jesse told him “I’m not sure I could either if I was in your place. But maybe, you need consider something else. The Kelly you loved, the Kelly we all loved, may never come back to us. She wouldn’t want you spending the rest of your life grieving for her and waiting for her to wake up if that ain’t never gonna happen.”

“Why can’t they just do it?” Bo asked in an exasperated tone “Why does Luke have to tell them it’s okay?”

“It’s an legal issue, Bo” Jesse explained “The hospital doesn’t wanna get sued for doing something against the families wishes.”

“I need to be with Kelly.” Luke said, shoving himself to his feet going through the doors into the intensive care unit. Jesse and Bo stayed where they were. Luke needed to be alone right now to think things out for himself. Whatever decision he made, the rest of the family would support him and be there for him, just like they always had been.

Inside Kelly’s room, Luke went to her side and sat down, holding her hand the way he always did. His rational mind accepted what Doc (and Jesse) had said, but his heart was breaking in two. “Tell me what I’m supposed to do, Kell.” He whispered, more to himself than to Kelly. He knew now that she couldn’t hear him (at least not on this level of existence) “How am I supposed to let you go? How am I supposed to go on without you?” Tears fell down his face unnoticed and without shame. “We were supposed to have the rest of our lives together. It wasn’t supposed to end this way.” He hung his head and began to cry.

The nurses hurrying about the unit, going about their everyday routines, averted their eyes but more then one of them felt the sting of tears. They all knew the tragic story of the young couple and the accident on their wedding day. More than one of them had secretly prayed that the young bride would survive even though they knew from professional experience that it was unlikely to happen. She was just hurt too bad. And it tore at their hearts to see the handsome young husband grieving so badly for the woman he loved. One of the nurses would transfer off the intensive care unit after that night, unable to watch anyone else suffering the way that Luke had suffered

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