Looking for an emotionally-resonant, thought-provoking read? How about one written by a nurse? Priscille Sibley’s The Promise of Stardust more than fits the bill! (Psst! Check out our Q&A with the author in the Fall 2013 issue of Scrubs.)
The riveting novel tells the story of a woman who suffers a devastating brain injury. Just as she’s about to be taken off of life support, her medical team realizes she’s pregnant. Her husband, a doctor, faces the dilemma of whether or not to keep her alive. Read the excerpt from The Promise of Stardust below…and put this one on your “must-read” list for the fall!
Excerpt from The Promise of Stardust:
The Emergency Room Call
Late that night—on our last night—we lay in awe, mesmerized again by the Perseid meteor showers as they transformed stardust into streamers of light. They were an anniversary of sorts for us, a summertime event Elle and I cherished, and we fell asleep on the widow’s walk of our old house, my beautiful wife curled up beside me, her head resting in the crook of my arm.
If only I stayed home in the morning—if only I’d looked over at Elle and realized nothing I could or would ever do was more important than keeping her safe. If only—Jesus—
I’ve heard patients’ families play the “if only” game. In the eleven years I’ve been a doctor, I’ve come to expect the denial and the bargaining. But reality is cold and hard and, all too often, irreversible. I did not stay home and neither did Elle.
I was already at my office, studying an MRI that showed what I suspected was a glioblastoma and wondering how much time I could buy my patient by excising his malignant tumor, when my receptionist buzzed me. “The hospital is on line three. Said it’s urgent.”
“Thanks, Tanya.” I picked up the phone, still staring at cross sections of the temporal lobe. “This is Dr. Beaulieu,” I said.
“Hi, Matt. It’s Carl Archer.” The emergency room doc cleared his throat. “You need to come over.”
“Page Phil. He’s covering the hospital.”
“He’s already here. I need you to come in. It’s your wife.” Carl’s voice sounded as tight as screeching tires. “She’s had an accident.” His tone, more than his words, conveyed the gravity. And its weight kept many questions tamped down in my throat. If Phil had already arrived, were Elle’s injuries neurosurgical? Or perhaps my partner simply happened by the ER. Maybe he was standing there telling Elle jokes to distract her from something minor.
Please, I thought. Don’t let her be dead. “Is Elle all right?” I asked. Carl cleared his throat again. “It’s serious. Come now. I’ll see you in a few minutes.” The dial tone sounded. I leaped out of my chair and charged through the waiting room, past a woman standing next to her wheelchair-bound son, barely turning to my receptionist to say where I was going.
After sprinting the four blocks to the hospital, I arrived at the emergency entrance in a cold sweat. I pushed through the double doors and headed straight to the trauma area. My partner, Phil Grey, stood next to a red code cart, its drawers open. He wore sterile gloves, a gown, and a surgical mask. An IV pole, decked out with a dozen IV bags and pumps, stood against the gurney. Lines of all sorts sprang from the patient’s extremities. Not Elle. Please, not Elle. The ventilator hissed its accordioned wheeze as it pumped oxygen into the hose coming out of her body. The nurse stepped aside, and I saw Elle’s face, white as the bed linens, dried blood caked in her blond hair. The only indicator that she was still alive was the tracing across the cardiac monitor.
Her body was rigid and arched, her toes were pointed, and her hands were curled under. The position is called decerebrate posturing, and it is an indicator of severe brain damage. I dropped to my knees, knowing whatever happened had devastated her brain.
I can’t say exactly what happened next. Maybe someone dragged me to my feet. Maybe I staggered up of my own volition. Phil said something about Elle and a fall from a ladder, something about a grand mal seizure in the ambulance. And Carl was hovering and saying something about a full cardiac arrest and a Glasgow score of five. Something—about being down for only four or five minutes. Something—about her fixed and dilated pupils. Something— about her CAT scan. Something—about surgery.
I touched Elle’s cold contorted hand. People were staring at me, pitying me. People I worked with. People I didn’t give a damn about. I pulled a light pen from my pocket and checked Elle’s pupils. Come on, Elle, I thought. React. Prove my gut reaction wrong. Prove. Them. All. Wrong.
I flicked the light across my wife’s green eyes, which weren’t green at all but black. Her pupils were blown and huge.
I checked her reflexes and found nothing but more evidence that the accident had destroyed Elle’s brain.
I met Phil’s eyes, eyes filled with tears. “Let me show you the CAT scan. I just put in the ICP monitor. Her pressure’s high. We started steroids and mannitol. I want to get her downstairs right now. I’ll do everything. D’Amato is scrubbing in with me. The OR is all ready for her.”
For a flitter of a second, I thought I would scrub in, too, but then my sensibility returned. I could no more cut into her brain or watch anyone else do it than I could turn into a superhero.
Phil held up the CAT scan that showed the bleeding compressing her brain tissue. I steadied myself against the wall. This could not be happening.
Less than twelve hours before, Elle and I had made love on the widow’s walk. I must still be sleeping there, having a nightmare, worrying about Elle leaning against the rickety railing. I had to force myself to wake up. As I glanced around—taking in the textures of the emergency room, the definition of the lines on Phil’s face as his logical mind planned out his surgical approach, the axle grease on the gurney’s wheels—I renounced reality in favor of believing it a vivid nightmare. Powerlessness pounded my denial like a drum. I wandered back into the trauma room as the nurse I now recognized looked up from checking one of Elle’s tubes.
No. This was real. And my wife, the girl I’d been in love with since I was seventeen, the girl who I had loved as my closest friend for an even longer time, had fallen and cracked her head open. Even the best neurosurgeon I knew, my friend and partner, would never be able to fix the damage.
For a minute, I stood frozen, remembering how much Elle did not want to suffer through a lingering death like her mother had endured. Phil shoved a consent form on a clipboard in front of my face. “Sign, so I can take her to the OR. I don’t need to explain this to you,” he said.
“We should let her go.” I turned and bolted into the bathroom, where I heaved my lunch. It felt like everything else I’d ever eaten came up in that scummy hospital toilet, too. Make no mistake; it is possible to turn inside out.
Phil opened the door and found me throwing up. “Matt, I need to take her downstairs. Now. We don’t have time for bullshit. Listen, horrible as this is, you know as well as I do, she probably won’t make it, but you’ll hate yourself if we don’t try.” He shoved the clipboard in my face again.
What did I promise Elle on our wedding day? That I would love, honor, and respect her. I had to respect her wishes. She wouldn’t want this. I knew the odds. I knew the consequences.
I grabbed the clipboard and scribbled my consent anyway.
He disappeared through the door, leaving me behind, regret- ting every betrayal I’d ever made of her. It was selfish to want her to live, knowing the kind of suffering she would have to bear, knowing her brain could never truly recover from a neurological insult this devastating. That was the trouble with being a neurosurgeon; I knew her prognosis. I could not be lulled by blind hope. Nothing and no one could save Elle. But I needed her. I needed Phil to save her even if it was impossible.
I splashed water on my face and returned to the trauma room. The nurse was setting up the portable ventilator so they could move Elle to the OR. “Can you give me one minute alone with her?” I asked.
The nurse sidled around the equipment and then touched my elbow like a visitor at a funeral home does a mourner. “We need to get her to the OR.”
I put my hand on Elle’s. The frigging IV was in the way. I bent down and kissed her cheek. I couldn’t kiss her mouth because of the endotracheal tube that was sticking out of it like an elephant trunk. “I love you, Peep. I’ve always loved you. Understand, I can’t live without you in this world. Come back to me. Please.”
Orderlies, a respiratory tech, and two nurses came through the door. They unlocked the gurney’s wheels and pushed Elle and the shitload of life-support equipment.
Left behind at the elevator, I walked around in circles. I had to tell our family, her father and my mother, and I had no idea how. I removed my cell phone from my pocket and stared at the screen alerting me that I had a voice mail from Elle. I held the phone to my ear.
“Hey, it’s me.” She sighed softly. “Can we do something tonight? Maybe we could take a walk on the beach? Listen, I know we made up afterward, but I am so sorry we argued yesterday. Let’s spend a little quiet time together this evening, talking and holding hands and . . . I love you so much.” She paused for a moment and then sounded like she was smiling when she continued. “Give me a call when you get this, and we’ll make plans for later, okay? I can’t wait to see you! Bye.”
I couldn’t breathe. Elle. Jesus. She had to be all right. Phil would get in there and the damage wouldn’t be as bad as the CAT scan indicated. I started muttering out loud. Elle was brilliant. If anyone could recover from a brain injury, she could. I’d work with her. She was resilient. Maybe I was misreading everything. I held the phone to my ear, listening to her voice again as I followed a current of people back to the ER. Carl was staring at me as I approached. I wanted to look at the CAT scan again. This was insane. Please, tell me. Tell me it’s not as bad as I think.
“I—I’m not sure what you said before. I guess I’m in shock. What exactly happened?” I asked.
Carl rubbed his forehead. “According to the rescue squad, they picked her up at her brother’s house. He’s out in the waiting room, by the way. Evidently, she hit her head on a rock after she fell about ten feet off a ladder. Your brother-in-law can probably tell you more about what happened. She had a long seizure on the way in, maybe ten minutes. She was in respiratory arrest when the EMTs got her here. They bagged her. We had trouble tubing her, and she went into a cardiac arrest, but we got her back fairly quickly.”
“How long was she here before you called me?” “Twenty minutes. We were busy, trying to save her,” he said. I swallowed while I tried to gather my thoughts. He wasn’t saying anything encouraging, and the mirage of my denial evaporated. “Where’s her CT scan?”
“Phil took it with him.”
Right. I’m not thinking clearly. “I have to talk to Elle’s brother,” I said.
As I turned toward the waiting room, the hospital CEO approached me and stretched out his hand. “Dr. Beaulieu. I heard that your wife is on her way to the OR. I hope it goes well.” He hesitated a bit before adding, “I don’t know if you’re up to it right now, but the press wants a statement.”
“The accident was on the police scanners,” Carl said. “If Elle McClure is rushed to the hospital, it’s news. She’s a local celebrity. Maine’s like a small town. They remember her from NASA.”
For a moment I was still at a loss, then I realized Carl was talking about the Space Shuttle. Elle was an astrophysicist, a college professor now. But four years ago she had actually flown in space and been part of a NASA mission, one which had garnered worldwide attention.
Carl fiddled with his stethoscope and nodded toward the CEO. “Listen, we can’t tell them anything, HIPAA laws and all that, but when you’re ready—”
“I can’t right now. Excuse me.” I had to talk to Elle’s brother. I pushed my way into the waiting room, a twenty-by-twenty-foot square with plastic benches and a flat screen mounted on the wall. Christopher stood with his back to me, studying the contents of a vending machine. I tugged on his shoulder, and he spun around.
“Matt, finally.” Christopher’s gaze frantically darted between me and the double doors of the ER. “No one will tell me anything.”
“What happened?” I asked. “Is she all right?”
“Not really. What the hell was she doing on a ladder?”
His mouth hung open for a moment. “Elle dropped by, and Arianne and I were washing windows, and the baby was hungry, so Arianne went inside to nurse her, and Elle said she’d help out, and she took over for Ari on the ladder, and I went back inside, you know, to work on the same window, make sure there were no streaks—and then Elle fainted. But she’s going to be okay, right?”
Fainted? The word registered on some back shelf in my mind. I tried to steady my voice and focused on the “Triage” sign hanging above the door. I couldn’t look Christopher in the eye as I pictured the CAT scan again. She’d arrested. Given her appearance and the decerebrate posturing, she had significant brain damage. I admitted the unfathomable to Chris and to myself. “No. I don’t think she’s going to be okay.” The room’s temperature felt like it dropped forty degrees. “Where’s your father?”
“Wait. What do you mean?” Christopher asked.
“It’s a bad head injury. Really bad. Where’s your father? Does he know she’s hurt?”
Christopher shook his head. “But she didn’t even fall that far. She cut her head and everything but—you’re a neurosurgeon. You can fix her, right? Did you see her? Did you talk to her?”
“She’s not conscious,” I said, trying to stay composed. “I saw her. I—listen, Phil took her to surgery. Call your father. Tell him to come in.” I blinked a few times. “Chris—she probably won’t make it.”
“What?” “It’s bad.” I turned around and walked away. Maybe it was cold to leave him with the prognosis, but I had someone else to tell. My mother. This would kill her. Or me. My mother was an obstetrical nurse—had been for almost forty years—but I didn’t know if she was working that day. I took the elevator to Labor and Delivery, passed security, waving my hospital
ID, and went to the nurses’ station. A couple people recognized me, smiled hellos, and one said, “Hi, Matt. Linney’s on break, but I think she’s in the lounge.”
I turned and beat my way past a laboring mother pushing an IV pole down the hall. She paused, evidently in the grip of a contraction.
Galloping laughter emerged from the nurses’ lounge as I pushed open the door. Mom sat at the table, holding a mug of hospital- grade sludge. She took one look at me and stopped short. “Who is it?” she asked.
“Elle. She had a fall.” And just like that, I was sobbing in my mother’s strong arms. Thirty-seven years old and I might as well have been one of the newborns wailing his first sounds of life. Except this felt more like a death cry.
Pick up a copy of The Promise of Stardust, by Priscille Sibley.