After the trauma of having the trach put in in the first place, the procedure to take it out had seemed surprisingly anticlimactic: one pull, and the tube had slid right out into the respiratory therapist’s hand. It hardly even hurt.
Brian had been slightly disturbed to hear they wouldn’t be stitching up the hole in his throat. “We don’t want any air getting trapped inside the stoma,” the respiratory therapist explained as she went over his discharge instructions. “It should close up on its own in the next couple of weeks without sutures. Until it’s fully healed, you’ll have to keep it covered at all times to prevent foreign particles from getting into your airway. Change the dressing once a day. You should wash the skin around the stoma with soap and water before you put on a new gauze pad.” She gave him a packet of information on how to care for the wound and sent him on his way.
It felt weird walking around with a hole in his neck, but Brian supposed it was a small price to pay for his freedom. He was lucky to be leaving Key West with his family and an otherwise clean bill of health. As he rode up the Overseas Highway in the front seat of Leighanne’s rental car, he kept running his fingers absently over the bandage. The area underneath was still tender, but each twinge of pain reminded him he was alive.
He gazed out the open window, his eyes lingering on the ocean waves like he had never seen water before. He savored the warmth of the sun on his skin and the balmy sea breeze blowing through his hair. It had been three weeks since he’d gotten to enjoy fresh air and daylight; he didn’t take either for granted.
“Are you getting too warm? Do you want me to turn on the air?” asked Leighanne from the driver’s seat, glancing over at him. Brian knew his wife was still worried about him; she had been walking on eggshells around him all day.
“I’m fine, honey,” he assured her, holding his hand over the dressing on his throat. The respiratory therapist had told him to cover the tracheostomy hole with his finger whenever he talked or coughed until it was closed. “The fresh air feels good.”
“Well, let me know if you need anything or want to stop somewhere,” said Leighanne.
Brian nodded. “Thanks, baby, but I’ve got everything I need right here.” He reached out and patted her knee, then turned around to smile at Baylee, who was riding in the back seat with Kevin. Between the two of them, he had been able to borrow enough clothing to get through the next few days, since he didn’t know what had happened to the bag he’d brought with him to Key West. His wallet, watch, and wedding ring were also missing, but none of that seemed to matter much at the moment. “I just wanna get to Miami so I can see Nick.”
“I know. I’m going just as fast as I can, Husband,” she replied, mistaking his anxiousness over Nick for impatience with her.
“You’re doing great, baby,” said Brian. “I’m just worried about him, that’s all.”
Leighanne bit her bottom lip, sucking one side between her teeth. “Me too,” she agreed, and he felt the car accelerate as she adjusted the cruise control.
As they sped across the Seven Mile Bridge between the Lower Keys and Marathon, Brian heard Kevin mutter to Baylee, “I bet you sure missed listening to all this lovey-dovey stuff between your mom and dad, huh, kiddo? ‘Husband’ this and ‘baby’ that…”
Baylee laughed, but answered back, “Actually… yeah, I kinda did.”
A lump rose in Brian’s throat as he looked over at his beautiful wife, admiring the way her blonde hair shone like spun gold in the sunlight. Without a word, Leighanne took one hand off the wheel and reached across the center console for his. As her right hand found his left, he laced his fingers through hers. It was such a relief to hold her hand again, he didn’t want to let go.
In spite of the hole in his neck, his heart had never felt fuller. Brian knew then that he was going to be just fine.
***
Nick, on the other hand, was not fine. In fact, he was about as far from fine as it was possible to be.
When Brian and his family finally made it to the hospital in Miami, Howie was waiting for them outside the intensive care unit. “We can only visit two at a time,” he explained. “Lauren had to fight just for us to be able to go in at all - at first, they were only allowing immediate family.”
“We are Nick’s family,” insisted Kevin.
Howie nodded. “I know. That’s what Lauren told the ward clerk. It took some convincing, but she finally let AJ and me through the doors. She knows us now, so we should be fine.”
“You guys go in first,” Leighanne urged Brian and Kevin. “Bay and I will wait here.”
“Thanks, baby.” Brian kissed her on the cheek before he followed Howie and Kevin up to the front desk. They showed their visitor badges to the woman behind the plexiglass window, and she buzzed them through the ICU doors.
“How’s he doing?” Kevin asked in a hushed voice, as Howie led the way down the hall to Nick’s room. Brian brought up the rear, moving slowly, for his leg muscles were still weak from being bedridden for so long. He didn’t have the strength to walk very fast or the stamina to walk very far. He knew he was lucky to be walking at all.
“Hard to say,” was Howie’s hesitant answer. “They’re keeping him in a medically-induced coma until he recovers enough to come off the ECMO machine, so he’s not conscious. He looks awful with all the tubes and stuff coming out of him, but at least he’s alive.”
Brian’s heart beat faster as he followed Howie. Kevin had filled him in on Nick’s condition as best he could, but having been in Key West for the past day, neither of them had a clear picture of just how critical it actually was.
As they passed other patients’ rooms, Brian couldn’t help peeking curiously through the clear glass doors. He caught glimpses of people who appeared to be asleep or unconscious, many of them tethered to breathing tubes and other pieces of equipment. The sounds of the machines and monitors mixed with the faint smell of disinfectant made his blood run cold, for it brought him right back to the funeral home where he and Nick had spent the past three weeks.
They stopped outside a door at the end of the hallway. Taking a deep breath, Howie turned and said, “Before you go in, there’s something else you should know.”
Brian and Kevin exchanged anxious glances.
“When they put Nick on bypass while he was in surgery, they hooked the tubes up to his heart,” Howie went on to explain. “Since they weren’t able to take him off it at the end of the operation, they had to leave the tubes in... so they couldn’t close his chest all the way.”
Brian felt a swooping sensation in his stomach as it suddenly dropped. Kevin was staring at Howie in dismay. “You mean his chest is still open?”
Howie nodded grimly. “It’s all covered with gauze and a sterile dressing so you can’t see inside or anything, but... yeah. The nurse said we can touch him, but don’t, like, jostle him and stuff like that.”
“Oh, damn - there goes my plan to jump on top of him and bounce on his belly till he wakes up,” joked Brian, pretending to be disappointed. “Just kidding,” he added quickly when Kevin gave him a look of horror.
“Not the best time to joke around, cuz,” Kevin said quietly, shaking his head.
“I don’t think Nicky would mind Brian joking,” countered Howie. “He'd want us to act normal around him.”
Kevin sighed, dragging a hand through his dark hair. “There’s nothing normal about this.”
No one could argue with that.
Brian took a deep breath before he and Kevin walked through the doorway and into the dimly-lit room, trying to brace himself for what he was about to see inside.
He noticed Nick’s wife first. Lauren was sitting in a chair next to her husband’s bed, holding his hand in her lap. When she turned her head and saw them standing there, she stood up, set Nick’s hand down neatly at his side, and hurried over to greet them. “It’s so good to see you, Brian,” she said graciously, giving him a warm but gentle hug. “I’m glad you’re here.”
“Me too,” he replied, plugging his hole with one hand while he patted her back with the other. “How ya been holdin’ up?”
She let out a humorless laugh. “Um… barely? How about you?”
Brian shrugged as she released him. “I’m okay. Better off that Nick, anyway,” he said bitterly, rubbing the bandage on his neck. “I’m so sorry, Lauren. I wish I could have done something to help him, but-”
“I know.” She nodded, looking at him with sympathy. “Howie and AJ told me what they did to you. I can’t even imagine what you must have gone through. I’m just glad you were able to get yourself out of there.”
“Nick gave me the strength I needed to do it,” said Brian, swallowing hard as he glanced past her to the bed where his best friend lay. “Honestly, he’s the reason I’m here right now. Hearing him talk to me, telling me to hang in there… that’s the only thing that kept me from giving up or going insane in that place. I hope I can return the favor for him.”
Lauren nodded again, her eyes full of tears. “Trust me, he needs all the strength he can get,” she said shakily. “His heart is so weak from the infection, it’s barely beating, and now they’re worried his kidneys have started to fail, too. These machines are all that’s keeping him alive right now.” She turned and made a sweeping gesture toward the equipment that surrounded Nick’s bed.
“He just needs to rest and recover,” said Kevin in his calm, soothing way. But Brian couldn’t help but think his cousin was trying to reassure himself as much as Lauren. “Sure, it’s gonna take him some time to gain his strength back, but isn’t that what all this is meant for? To buy him more time until he gets better?”
“That’s the goal,” agreed Lauren, sniffling as she wiped away her tears, but behind her brave face, Brian could tell she was terrified of losing her husband. He understood. He was scared, too. “Listen, I’m gonna go use the ladies room and let you guys spend some time with him. I’ll be back in a little bit.”
“Take your time,” Kevin told her. “Get yourself some food or a cup of coffee or something. Howie’s outside in the hall if you want him to go with you.”
Lauren forced a smile. “Thanks. I just hate to leave Nick for too long.” She looked back at her husband’s bed. “He’s so heavily sedated, it’s not like he’s gonna wake up while I’m gone, but still… I don’t want him to be alone.”
“He won’t be alone,” Brian said hoarsely, holding his bandage as he shook his head. “We’re not goin’ anywhere. We’ll stay with him until you come back.”
“Thanks, guys. You’re the best,” replied Lauren, misty-eyed once more. She hugged them both, but before she left the room, she returned to Nick’s bedside and picked up his hand again. “Brian and Kevin are here,” Brian heard her murmur to him. “They’re gonna sit with you while I go to the bathroom, but I’ll be back. I love you, babe.” She planted a tender kiss on Nick’s knuckles, cradling his hand between hers before she put it back down.
When she finally forced herself to walk away, Brian and Kevin stepped forward to take her place next to Nick’s bed. “Sit down, cuz,” said Kevin, offering Brian the chair, but Brian just stood beside the bed, staring down at his little brother in disbelief.
If Nick had looked bad before, it was nothing compared to how he looked now. His body was bloated from fluid retention and lost beneath a complex tangle of tubes that had been inserted into his chest, neck, mouth, nose, arms, and places Brian couldn’t see beneath the blanket that was covering his lower half. He felt queasy at the sight of two thick tubes protruding from the center of Nick’s chest, dark red with the blood being pumped in and out of his body by the ECMO machine. The area around the tubes was packed with gauze pads, tinged pink with traces of blood, and covered with a clear dressing that looked almost like plastic shrink wrap. Brian didn’t want to see what was under the gauze. The mere sight of the thinner drainage tubes placed at the base of Nick’s breastbone reminded him so much of his own heart surgery, it made him break out in cold sweat. The sound of the ventilator hissing as it forced air into Nick’s lungs was another trigger, taking Brian back to the funeral home and the feeling of not being able to breathe on his own.
His fingers fiddled with the bandage on his neck as his eyes drifted to the bedside monitor that displayed Nick’s vital signs. He didn’t know what all of the numbers meant, but he recognized that while Nick’s oxygen level was within the normal range, his blood pressure was still low. The wavy line that represented his heart rhythm was irregular, rising and falling at random intervals. In between these brief spikes of electrical activity, the line went flat.
“If you’re not gonna sit down, I will,” Kevin said suddenly. Brian looked over at his cousin as he lowered himself into the chair beside the bed. Kevin’s face was as white as a sheet, and his hands were shaking.
“Hey, you okay?” Brian asked in concern, patting Kevin’s back. He could feel cold sweat seeping through the thin fabric of his t-shirt. “Don’t you go passing out on me, man.”
Kevin put his head in his hands, grabbing fistfuls of his hair with his fingers. “I know Howie tried to prepare us, but… damn. It’s just hard to see him like this,” he muttered. “It’s almost as bad as it would be if it were one of my kids, you know? I mean, we watched him grow up. We practically raised him, in a way.”
Brian nodded, a lump rising in his throat. “I know. You don’t have to look if it bothers you. Just being here is enough. It helped me to know Nick was nearby when we were both trapped in that place. At least we were together. Like I told Lauren, he kept me calm… kept me from losing my mind.” Holding his bandage, he swallowed hard. “We just need to talk to him and let him know we’re here. Even though he’s not awake, he may still be able to hear us.”
Kevin took a shuddering breath and let it out slowly. “Why don’t you go first?” he suggested. “I’ll be fine; just give me a minute.”
“Okay.” Brian cleared his throat as he picked Nick’s hand up off the bed, like he had seen Lauren do before. In spite of his fever, Nick’s swollen fingers felt surprisingly cold. Brian rubbed Nick’s hand between his two, trying to warm it. “Hey, buddy… it’s me, Brian,” he said softly. “You’re safe now, Nick. We both are. We’re at a real hospital, with doctors and nurses who want to help you, not hurt you.”
He watched Nick’s face carefully as he spoke, but of course, there was no sign Nick had even the faintest awareness of him. Still, Brian continued as if Nick could comprehend everything he was saying, the same way Nick had done for him during his “coma. Brian had hung on to every word. For all he knew, Nick was, as well.
“Kevin’s here, too,” he added, looking back at his cousin, “and Leighanne and Baylee… Howie and AJ… and, of course, Lauren. We all love you so much.” He gripped Nick’s hand tightly. “Hang in there, man. Just like you told me to. You were right all along - I wasn’t really in a coma, and I could hear you talking to me the whole time. Hopefully you can hear me, too.”
He glanced again at the heart monitor, remembering how Nick had seen his heart rate rise when he was talking to him, but Brian didn’t notice any difference in Nick’s barely-there heartbeat.
“If you can, I don’t want you to worry,” he went on anyway. “You’re in real good hands, and you’re gonna be all right. You just need to rest so you can fight off that infection and focus on getting better. I’m gonna be here to watch over you and make sure you’re being taken care of. I won’t let anyone hurt you this time.”
He gave Nick’s hand another squeeze as his eyes shifted back to his blank face. It was pale, almost ashen, but the blue tinge Brian had noticed around his lips before was gone. “You know, Kev, his color actually looks a lot better than it did back in that place,” said Brian, trying to focus on the positive. “I don’t know what they did to deprive him of oxygen, but his lips were practically blue. They’re back to light pink now. That’s gotta be a good sign, right?”
Kevin nodded. “Probably,” he agreed. His own pallor had improved as well.
“Wanna trade places with me?” Brian asked him, setting Nick’s hand back down on the bed. “My legs are getting tired.”
“Oh, yeah, of course,” said Kevin, scrambling up from his chair so his cousin could sit.
Brian leaned back in the surprisingly comfortable chair and let Kevin take Nick’s hand and talk to him awhile. He listened with tears in his eyes as Kevin whispered his own words of love and encouragement to their little brother, but it wasn’t until Lauren came back and he and Kevin left the room that Brian allowed his tears to fall.
***
