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CRASH!

A Mother, a Son and the Journey from Grief to Gratitude

DUE OUT 2012 (GLOBE PEQUOT PRESS)

After 25 years of caring for children, first as a nurse, then as a doctor, I suddenly found myself on the other side of the stretcher when my son Neil, then 17, was hit by a drunk driver while walking his girlfriend home after a study date. She did not survive her injuries. Neil carries his with him to this day.

Gratitude for Neil’s survival gradually gave way to grief. While initially told Neil’s only injury was a broken leg, I soon found myself in the front seat of an ambulance heading to an ICU in Boston. Neil’s brain was bleeding. This world I so easily navigated, first in a white uniform, then a white coat, suddenly looked very different. Now I wasn’t somebody’s doctor or nurse. I wasn’t in charge any more. I was the patient’s mom.

There are many dividing lines in this story: the line that cut my family’s life in two: the events that occurred before the crash and those that came tumbling and faltering in its wake. The line that separates grief from gratitude: gratitude that Neil is alive and as whole as he is; grief for his loss of memory, changed personality and for having his life shattered in an instant. The line that separated the world I knew so well as a nurse and a doctor from the one I must now navigate as the parent of a trauma victim. There are also the lines that kept me from Neil over and over again: the tiny square window in the cab of the ambulance. The sliding glass window of the triage desk. The strict rules of the ICU. Time and again, I was kept from my son by the medical community I had been a member of for so long.

In my new memoir CRASH!, I explore all of these boundaries: between then and now, grief and gratitude, before and after, us and them. As a “medical insider” I will bring you into a world that is not usually open to the public. And maybe we will shed a tear together or share a laugh along the way.

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QUOTES AND COMMENTS

Paula Jolin of The Sun calls Roy-Bornstein “a talented writer” and her pieces “intense.”

Elizabeth Roca of Brain, Child the magazine for thinking mothers finds Roy-Bornstein’s writing “very moving.”

Tracy Mayor of Brain, Child calls it “very moving” and “well-realized.”

Sanford Kaye, author of Writing Under Pressure, says “there is nothing more powerful than this… I felt like I was holding my breath.”

Excerpt

FROM CRASH!

When Neil was a sophomore in high school he played Tybalt in Romeo and Juliet. He had few lines but a formidable stage presence with his fierce anger and menacing bluster. He choreographed his own fight scenes, expertly clashing sword against sword, first with Mercutio, then Romeo. Advancing. Retreating. Slicing. Thrusting. A perfect dance. The theater was silent except for the soft shuffle of gliding feet, boots landing on stage in perfect balestra, swords clanking, first high then low.

And then, the death scene. Romeo plunged his dagger deep into Tybalt’s chest. Neil’s chest. My son. He fell to the ground. Juliet dropped to her knees and cried over him.

“Tybalt my cousin. O my brother’s only child.”

(“Doesn’t that make me your nephew?” Neil would joke during rehearsals, cracking Juliet up every time.) But this was opening night and he wasn’t joking. And Juliet wasn’t laughing. She was weeping and so was I.

His fellow actors came on stage and lifted Neil reverently onto a slab of wood, then covered him with a pure white shroud. They walked slowly, as if marching to a silent dirge. They placed him carefully onto a makeshift bier, two foot-high blocks of wood pushed together at the back of the stage.

And there he lay for the rest of Act III. Scene after scene played out. Romeo. Friar Lawrence. Lady Capulet. Nurse. Their lines were silent to me. Their movements unseen. My eyes were glued to the body at stage rear. Neil’s shroud was made of a gauzy fabric. I could see his facial features beneath its flimsy folds. I tried to detect some movement. A breath. A twitch. But there was none.

It filled me with sorrow and dread watching my son, dead on stage. The rest of the audience was at a play. But I was at a wake, staring into a coffin and waiting for the victim to rise.

“I’m sorry my son keeps killing your son,” Hal’s mother joked after the performance. We chuckled together, but I could not shake the feeling of doom that had enveloped me since Neil’s onstage demise.

Now, three years later, an ER nurse was taking me to my boy. And there he was again. My son. On stage. Behind a curtain. Under a shroud. On a bier. But now the stage was an ER cubicle. And the curtain here was stark white, not velvet red. His shroud was a sheet pulled up to his neck. His bier, a hospital stretcher. His clothes were lying in piles on the floor around him, cut from his body in haste. I tried to detect some movement. A breath. A twitch. I moved closer to his side. His head was wedged between two big Styrofoam blocks secured by thick white adhesive tape. I laid my hand across his forehead. His eyes fluttered open.

“Hi Mom.”

He knew me. I felt a rush of relief. But he drifted immediately back into unconsciousness and my brief elation gave way to a gathering knot of fear. A doctor came in and gave me the rundown on my son. At first she told me his only injury was a broken leg. I lifted the sheet between my thumb and forefinger and peeked underneath while the doctor continued her update. Neil’s lower leg was badly deformed; his fractured shin bone strained against his skin at an unnatural angle. Dark blood pooled just beneath the surface. My stomach turned in response. Though I have scrubbed in on dozens of strangers’ surgeries over the years and patched together many patients’ gashes and scrapes, I have always been totally squeamish when it came to the slightest wound on one of my own.

The doctor’s words drifted back to me. “CAT scan. . . Just a precaution. . .Out at the scene.”

I tried to follow her general drift. Neil would be okay. He had a broken leg. They were CT’ing his head as a precaution. I’ve talked to hundreds of parents in emergency rooms and ICUs. I’ve been the bearer of bad news or at least uncertainty more times than I can remember. I know people shut down. I know they can only take in so much. I’ve learned to slow my pace, to read the signs in patients’ eyes and faces that this is enough. The well is full and I should stop dumping information into it. And now here I was on the other side of the stretcher, trying to comprehend what was happening. My son recognized me. That was good. But he was sleeping. That was bad. He was not asking what happened. He was not asking for Trista.

I could not be alone. I had to reach Saul. But I couldn’t leave Neil alone either. I stepped out into the hall clinging ridiculously to the curtain that hung from the ceiling and separated Neil’s cubicle from the bustling hall, as if it were some kind of mooring that anchored me to my son. As if by holding onto the curtain I was protecting myself from being swept away from him. I recognized the Fire Chief pacing in the hall. Our kids played soccer together years ago. (A lifetime ago!) His hand rested lightly on his two-way radio.

“Steve, can you get a message to my husband? He’s playing volleyball at the Salvation Army.”

“I’ll see what I can do,” he said and strode off, on a mission.

I returned to my son’s side. There was no chair in his cubicle so I stood over his stretcher, looking down on his sleeping face. I ran my hand through his long brown waves. His eyes opened sleepily.

“Hi Mom,” he said again. But it was as if he was seeing me for the first time. I shivered.

A nurse entered and deftly released the brakes on Neil’s gurney with her foot while simultaneously swinging the bed around and wheeling him out the door and down the hall. She called to me over her shoulder, “You can follow us to CAT scan.” I fell in line behind the speeding procession.

We passed Trista’s cubicle which was next to Neil’s. It was humming with activity. Monitors beeped. Doctors barked orders. Someone was crying. I kept my focus on my son. The nurse wheeled him into the radiology suite, motioning toward a couple of lonely plastic chairs in the bare hallway. I took a seat and waited.

A faraway jangling sound drew my attention down the long corridor. A uniformed police officer was striding up the hall, his heavy keys bouncing against his leg as he walked. He was escorting my husband to us. Saul broke away from the officer when he spotted me and I rushed to meet him. My husband is a big man with strong broad shoulders, accustomed to moving industrial refrigerators and wrestling two ton walk-in coolers into place. But as he raced down the hall to me, his arms open to gather me up, his frame was heavy and bent.

“He’s okay,” I blurted out, more because I could see how panicked Saul was than because I believed it was the truth. We held each other. I was relieved to see my husband. I was glad to have someone to talk to, to be scared with, to hold onto. But I realized that no one was going to relieve me of the burden of duty. This was my world. Ambulances. Hospitals. ERs. I would be the interpreter, the bridge. If there were decisions to be made, I would gather all the necessary information and make them. With the facts and on my own. I could not let my guard down. I did not feel strong enough for this.

As we withdrew from our embrace, I could see the police officer slowly turn and head down the hall, his mission over here. I tried to fill Saul in on what I knew. The broken leg was a definite. But after that I was on shaky ground. The CAT scan had been presented to me as a mere precaution. Probably overkill. Doctors just being thorough. But the more Neil slept and the more he repeated himself every time he saw me, the more I worried about his brain.

The scanner door opened and the nurse pushed Neil’s stretcher back down the hall toward his room. Saul bit his lip and touched Neil’s head as they moved.

“Hi Dad,” Neil said, monotone, and then closed his eyes again. Saul looked at me with a smile and a sigh of relief. My heart cracked. I felt almost nostalgic for that sense of relief that I, too, had experienced just moments ago when I realized Neil was alive and knew me. But even though Saul was only minutes after me in responding to our son’s accident, I felt like I was light years ahead of him in understanding the magnitude of what was happening. Not just because of my medical training, but because Neil was repeating himself. His recognitions were without emotion. He seemed a shell.

We sat together waiting for the doctors to tell us the results of the scan. This time our chairs were closer to the action. A group of scrubs huddled in front of the light box and murmured over someone’s films. I wanted to join them. Render my own interpretation of the images. I strained to hear their words over the ambient bustle. “Brain.” “Fracture.” “Bleed.” I knew they were talking about Neil. When they turned and walked toward us like one organism, I squeezed Saul’s hand hard.

“Your son has a fractured skull,” one of the scrubs explained. “There’s a tiny bit of bleeding at the site,” another added. “Nothing big really. But we’d like to transfer him to Boston. Just in case.”

‘In case he needs a Richmond Bolt,’ I thought. ‘An intracranial pressure monitor.’ I tried to push visions of Neil’s shaved and bandaged head out of my mind.

They led us back to Neil’s cubicle. He was more agitated now. His leg was hurting him. He thought he was in a gym. After each arousal, he fell back into a deep sleep. Saul and I stood over him, our hands on his shoulders feeling helpless and scared.

The noise level outside our cubicle rose. I could hear Mary wailing. Police walkie talkies crackled. Trista’s brother Bud was pounding his fist into the arm of a metal chair in the hall sputtering over and over, “I’ll kill him. I’ll kill him.”

“I have to go say good-bye,” I told Saul and stepped into the hall. A crowd surrounded Trista’s stretcher. Her head was taped between two Styrofoam blocks, like Neil’s. She was intubated. A respiratory therapist knelt against her, pressing air into her lungs rhythmically with an Ambu bag. A nurse was securing her heart monitor to the stretcher’s side rails with Velcro straps. I stepped closer. Someone had put ointment into Trista’s eyes to keep them moist. Despite the bright glare of the ER’s fluorescent lights, her pupils yawned widely open. I swallowed hard, knowing what that meant. Fixed and dilated. I kissed her forehead.

“Good-bye, Sweetheart,” I whispered. The helicopter crew arrived and whisked Trista out the door. I never saw her again.