RESPONSE TIME | Dena Brownstein
Thirty-five years of working in the emergency department did not prepare me for that night.
The phone rang, startling me awake. Snug under a down comforter, struggling to regain my bearings, I glanced at the screen before picking up the call. 10:20 PM.
“This is Officer X with the Seattle Police Department.”
Instantly alert, I rode a wave of adrenaline.
“Is this the mother of M?”
He told me that my daughter crashed her Volvo into a tree at high speed. The accident happened on the lakefront boulevard not a mile from our home.
“She’s alive,” he said.
I’d retired from my career as an ER doc only months earlier and recognized this as code-speak for “almost dead.” He asked if I knew how to get to the trauma center, implored me to “drive safe.”
Quaking, nauseous with fear, feeling profoundly unsafe, I pulled on jeans and a fleece. My husband was at our second home on an island eighty freeway miles and a boat ride away. There were no ferries running at that hour.
A neighbor― an old friend who had known M since birth ― drove me to the hospital. He offered to stay but accepting sympathy might have cracked my fragile emotional armor. I could not bear a witness to my unraveling and sent him off.
The front desk clerk, seated behind a sturdy glass panel, looked up from her computer screen.
“I got a call from the police. The medics brought my daughter here,” I said, my voice urgent, my heart racing.
She asked for a name. Her long manicured nails clicked away at the keyboard. I confirmed my daughter’s date of birth, address, insurance information.
“Have a seat, ma’am,” she said. “I’ll call the social worker.”
Pacing the scuffed linoleum, I avoided eye contact with the other wretched souls waiting their turn for care, or for bad news. I did the mental calculus, my ER brain whirring in a synthesis of fragments of information: consigned to the waiting room; a social worker instead of a doctor.
The cell reception was tenuous, but I woke up my husband on a second attempt. “I think she’s dead,” I told him, weeping.
I was sure she was dead.
Hearing my name announced, I hung up hurriedly, promising my stunned husband I’d call back. The social worker was clearly harried, there to communicate the facts but too pressed for time to offer support. M was alive, though critically injured.
Shocked into a facsimile of calm, I followed the social worker into an institution-beige corridor, where she handed me off to a pony-tailed police officer and disappeared down a maze of hallways. The officer was there to guard her prisoner, my 27-year-old daughter, suspected of driving under the influence. There was not much guarding to do. M was comatose, not a flight risk.
Time dilated. I hovered outside my body, spectator to the unspeakable as the officer described the accident scene.
“She was driving north, but drifted into oncoming traffic.”
Later, I would read the police accident report. M, driving, made no apparent attempt to correct course before colliding with a tree at high speed, ripping the front and rear bumpers from the car, shattering most of the windows. Unrestrained, she’d been launched into the windshield.
“The medics thought they’d have to tube her, but she kept breathing. She never regained consciousness.”
Hollowed out by horror, I squelched the impulse to push my way through the double doors to the trauma bay, the heart of the ER. I waited for minutes that felt like hours. Finally, a nurse ushered me and the officer in.
I was used to being the doctor in charge, barking out orders under the glare of surgical lights in a room littered with discarded packaging, bloody gauze, the detritus of an ongoing resuscitation. But on that night, the officer and I stood pressed against the wall, bearing mute witness. I could barely see the battered body of my youngest child on the stretcher through the scrum of scrub-clad figures.
In short order, a CT scan popped up on a screen. I recognized the bright white crescent of blood pressing a swollen brain tight against the rigid confines of her skull. The neurosurgeons were nonchalant; they would hold off on surgery and repeat the scan in a few hours.
My daughter’s multiple facial fractures were just a sideshow, no life-threatening injuries there. The otolaryngology team signed off. Her beautiful, smashed-up face could wait.
“We need to get her to the OR,” said the orthopedic spine doc, handing me a surgical consent that I signed as a proxy for my unconscious adult child, still my baby girl. I entrusted my daughter and her broken neck to the hands of people whose competence and care I had to take on faith.
M was, against the odds, alive. The medics and the trauma team had saved her life. I was grateful. I was frightened. I was helpless. The complex web of our lives leading up to this terrible moment was irrelevant to the doctors and nurses racing from one emergency to the next. M was just another drunk driver, and I was just another grieving mother.
Strangely, the police officer, clad in regulation navy blue, gun holstered, was the most empathetic of the cast of characters I encountered that grim night.
“But M doesn’t drink,” I protested, when she told me that the first officer on scene smelled alcohol on M’s breath. She did not correct me, though a lab test would soon prove me wrong.
“I would have brought her in and left,” she said, almost apologetic about being required to stand watch. “My partner’s a rookie. He wanted to do it by the book.”
The officer was there because my broken daughter had broken the law, but she was the only person in the ER who made me feel seen, acknowledging that this was— for me, for us — a tragedy.
An anesthesiologist wheeled M, still unconscious, off to the OR. The officer headed to her squad car, job done. On her way out, she handed me an arrest warrant and an invoice from the tow company.
M spent a scant two days in the trauma ICU and one more on the step-down unit. Her neck was encased in an exoskeleton of white plastic protecting a trove of hardware. When jostled awake for scheduled neuro checks, she remained groggy, confused, repeatedly failing to locate herself in time or place. She had no recollection of the events leading up to her crash, or of what had transpired since.
Short stays are routine in busy hospitals. But these were not routine times. News from Italy was dire, hospitals overwhelmed, people dying while awaiting care. The first U.S. case of COVID-19 had been reported five weeks before M’s crash. Since then, twenty-seven cases had been confirmed in our state, including nine deaths. It would be another few weeks before our governor would announce the first lock-down, but the trauma center was already bracing for impact. M needed no further surgical intervention. She had a home and people to care for her. Better yet, she had a doctor mom.
We were ushered by a transport tech to our Subaru, M in a wheelchair, me clutching the flimsy plastic handles of two hospital “personal belongings” bags stuffed with extra pads for her cervical collar, gauze, tape and gloves to re-dress the six-inch surgical wound on the nape of her neck and a sheaf of discharge papers listing multiple follow-up appointments yet to be made. No one knew then that outpatient clinics would soon be shuttered. There would be no PT or OT evaluations or substance-abuse treatment. We were pretty much on our own, our family drama dwarfed in significance by an evolving pandemic.
M crashed her car two months after my retirement party. I had barely begun my uneasy exploration of leisure when conscripted into an exhausting schedule of medical and emotional caretaking in my own home. Accustomed to the thrum of the ER, the camaraderie of a team and the ability to leave at the end of a shift, being on non-stop call proved debilitating. My layers of fear―M’s recovery, the virus― were a heavy weight I could not put down. She remained in harm's way, mobile but unmoored, conjuring explanations to fill the expanse of time wiped clean by post-traumatic amnesia. My own grasp on time loosened in that intersection of recent retirement and COVID lockdown. A largely blank calendar was tacked to our kitchen wall. There was only the occasional Zoom meet-up or furtive masked foray to pick up M’s prescriptions to interrupt my drift through days, weeks, months. Was it Tuesday, or Saturday? There were days when I’d have to check my phone to be sure.
I spent hours on the internet searching out services, waited on hold with clinics and programs as a recorded voice assured me over and over that my call was valued. I often gave up in frustration. I knew how the system worked, and how to work it. When I’d been diagnosed with cancer, or my husband with a bad heart, I brushed off my ethical qualms and pulled the levers of privilege to access packed schedules, jumping the line. Now, there were few levers to pull.
After leaving scores of unanswered messages, I did play my doctor card and contacted a neurosurgical colleague. He advised me to abandon my quest to arrange the follow-up head CT advised at M’s discharge, assuring me the scan would reveal nothing actionable.
“What you need to watch out for,” he said, “are anxiety and depression.”
Hers, I wondered, or mine?
I was not alone with M during the dark days in COVID lock-down, but I was lonely. Friends and neighbors had stood with us through so many crises with M over the years, but they were hunkered down, leaving their homes only for hasty grocery runs or vain searches for bleach or hand sanitizer.
My husband, M’s father, stayed the course, as he always had, as he always will. We supported each other as best we could, but our ways of managing grief and fear were divergent. When he teetered on the edge of his distress tolerance, I would send him off to the respite of our island cottage. I did not have the capacity to take care of him too.
I dared not wander so far, too terrified by a vision of disasters that might transpire in my absence, though I knew my bid for control was illusory. Proximity had never been enough to keep M safe.
Early on, walking a lakeside path just blocks from our home in my own bid for light and air and space, I would pause at the crash site. The sturdy tree that stopped M’s heedless hurtle bore scars of the encounter, a sizable section of fissured gray-brown bark sheared loose. The pavement had been swept by a city crew on the night of the crash, but in the weeks following I found artifacts, a shower of tempered glass fragments sparkling in the sun, unidentifiable lengths of metal, bits and pieces of her sound system ejected through blown-out windows.
As the months passed, walking the lakeside path became an escape from a functional prison of high emotion and unpredictability, a way to gain distance while staying close and keeping the wily virus at bay.
Some outings came to an abrupt end when I got an urgent text. I’d hurry home to scenes reflective of the disorder of M’s injured brain, her uncontrollable cravings, distractibility and easy frustration. The wreckage of an abandoned kitchen adventure, her cats mewling hungrily.
At other times, I was lulled into a sense of well-being by the simple act of putting one foot in front of the other, medicine in movement.
I walked to let my litany of distress play on repeat until the words lost their power.
I walked to feel sun on my skin, admire the mountains on the horizon, still robed in white.
I walked so I could breathe.
There was no catharsis. No moment when light streamed into the tunnel of our days and I realized we would emerge into a recognizable world. As an ER doc, I didn’t follow patients through their long recoveries. Convinced at four months, eight months, even a year out from the accident that she was back, albeit to some new normal, I was crushed by serial reminders that M’s invisible wounds remained open. She could cover her cognitive deficits and mask her emotional dismay for stretches of time, go to work, help with dinner, but her mind remained muddled, a current of deep shame and horror running just beneath the surface. She struggled to claim her equilibrium, and there were days and weeks when she could not. I had learned long before that I could not make things right for her. Shelter, food, love, constancy―these were what I could give. I did. I do.
Five years after the crash, on the other side of the pandemic, our home has regained a semblance of calm.
M’s fractures are long healed, her brain fog cleared. She sought help to escape the choke-hold of alcohol, labored hard to reclaim her tilt to optimism. A summer spent in the garden proved restorative, respite in the quiet rhythms of cultivation. She has a good job. She has rebuilt a life. She remembers little of the darkest days.
My husband and I are kinder to each other, less reactive, bound by a shared vulnerability, the knowledge that loss lurks in the corners. We live with an amplified sense of urgency to hold tight to what we love.
I read and write, attend to friendships old and new, volunteer to support immigrant rights, protest threats to our democracy. I am busy out in the world but take my long solo walks along the lakeside path almost daily. I no longer stop at the tree, no longer grounding my life in that devastation. Free to wander further, boarding an airplane requires a dose of self-coaching. I still worry that something dire will happen in my absence.
Healing the spirit― healing broken hearts―takes longer than mending bones.
Dena Brownstein is a retired pediatric emergency physician, mother of two adults, writer and community activist. Family, career and aging are the topics that inform her forays in creative non-fiction. Brownstein lives in the Pacific Northwest, and splits her time between Seattle and Lopez Island in the Salish Sea. Both landscapes feed her soul.