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Inner Hell - Chapter 12
Evaluation

There were plenty of questions swimming through Brian’s mind, none of which he wanted to ask. He walked quietly behind the doctor and AJ, wondering what state they would find Nick in this time.

Dr. Garcia stopped outside of Nick’s room and turned to face Brian. “I’m a third year medical resident. This is a teaching hospital and I’m just evaluating Nick, I’m not going to get anyone into trouble by doing this. If I see something that needs to be addressed, I will speak with Dr. Langston, the head of Neuro. Relax, okay?”

Brian grinned slightly and nodded. “How do you know what I’m thinking?”

The young doctor returned Brian’s grin and shrugged her shoulders. “Experience I guess.” Without hesitating, she confidently pushed open the door to Nick’s room, Brian and AJ in tow.

Brian’s heart sank as he looked at his young friend. He was hoping that Nick’s eyes were still open, but they were closed and he looked as he had always looked - locked in a deep sleep.

Dr. Garcia flipped open the thick chart and thumbed through pages until she found what she was looking for. She quietly read the information and then set the chart down on the bedstand, walked over to the sink and washed her hands.

“Good morning Nick, my name is Michelle and I want to take a look at you,” Dr. Garcia announced in a cheery voice.

“He can’t hear you,” AJ stated as he glanced at Nick’s face.

Both Brian and the doctor looked at AJ.

“No kidding?” Brian replied in a sarcastic voice.

AJ folded his arms across his chest and laughed nervously. “Forget I even said that, okay?”

“We will,” Dr. Garcia and Brian said simutaneously.

The two watched the doctor conduct the routine vitals they had grown accustomed to seeing done on Nick time after time. She scribbled some of the vital signs down on a slip of blank paper and then placed the stethoscope onto the bedstand.

“Okay, AJ what have you seen Nick doing?”

“I, um, I haven’t seen Nick do anything besides sleep. He moaned once and that one fuckin’ doc said that’s about all Nick will probably ever do.”

Brian blushed at AJ’s choice of words in front of the female doctor.

“The chart mentioned that he had opened his eyes,” Dr. Garcia stated.

“I saw him do that,” Brian offered.

“Okay, please explain to me what happened.”

While Brian gave his description about Nick’s reactions, the doctor wrote notes on the paper, nodding and glancing at Nick’s sleeping form occasionally. When Brian finished, she placed the pen down and approached the side of the bed.

“Nick?”

AJ and Brian waited for a response. The doctor clapped her hands by Nick’s ears.

“HEY! He’s making a face!” AJ gasped. It was the first time he saw Nick do anything in weeks.

“He doesn’t seem to like loud noises,” Brian pointed out.

The doctor placed her thumb and forefinger into her mouth and let out a shrill whistle. A startled Nick scrunched his face and his eyes flew open, staring blankly out at the room.

“Nick!” AJ cried out when Nick opened his eyes.

“Okay, now we’re getting somewhere,” Dr. Garcia breathed as she looked at her young patient. “Nick, I’m Dr. Michelle. Can you look at me?”

Nick stared ahead of him, eyes fixed towards the blank wall at the foot of his bed.

“Nicky, the doc is asking you something...”

AJ stopped his sentence when he was elbowed by Brian. He shushed his friend and gestured towards the bed. “Let her do her work,” he whispered.

“Nick,” the doctor started out as she placed her face in front of Nick’s. “Do this,” she commanded as she stuck her tongue out. Nick’s eyes focused on the woman’s face. He watched her stick her tongue out but at first did nothing. “Nick, do this,” she commanded again and stuck her tongue out.

At first, their only reward was Nick focusing on the doctor’s face. Brian held his breath when he saw what was happening, grabbing AJ’s arm.

“Nick, can you do this?” the doctor asked again, in a louder voice.

AJ sighed. “He’s not deaf ya know!”

Brian shushed AJ and gave him a stern look.

They were finally rewarded with Nick slightly sticking his tongue out at the doctor.

“Good Nick!” she praised him loudly, smiling at him. “Okay, Nick can you do this?” she asked as blinked her eyes. Nick made a face and then slowly copied the command of blinking his eyes for the doctor. Again, she praised him.

“Do this now,” Dr. Garcia asked as she clenched her teeth and parted her lips. After a few moments, Nick’s eyes drifted past the doctor, focusing on the blank wall again. “Nick? Nick?”

******

Brian and AJ waited in anticipation for Dr. Garcia’s report about Nick. After doing her evaluation, she excused herself and left the two men sitting in Nick’s room.

“Hey, don’t you think staring at the wall is getting a little old?” AJ questioned as he looked in the direction of Nick’s gaze.

No signs of response came from Nick and AJ sighed.

“I think you have to speak louder for some reason,” Brian wondered outloud.

“Ya know that bugs the shit out of me too. Why are they acting like he’s got brain damage? He wasn’t in an accident. He just drank too much and took some meds by accident. This doesn’t make any sense to me at all. If I had stayed with---”

“Don’t,” Brian interrupted, placing a hand on AJ’s shoulder. “It’s not your fault, there’s nothing you could have done differently, we didn’t know this would happen.”

AJ shook his head as he wiped the tears that had fallen onto his cheeks. As the door swung open, AJ stiffened in his chair, composing himself.

“Okay, I’ve gone through Nick’s chart and all the tests results and evals that have been done with him over the past two weeks. I see that when he was brought into the ER his blood alcohol was .14 so he had to have had a lot of alcohol in his system when he went to bed that night. The toxicology report shows a few drugs, a mixture of pain meds but they were unable to determine how many and exactly what type he had taken and how long ago he had ingested them. When he arrived they classified him as a stage 2 score was a 6. He only had response to pain and that was his body pulling away from the source.”

She sighed before she continued. “After checking him over, my findings are that he now can be classified between a stage 4 and a stage 5, his score is now a 9 meaning that he is in a moderate impaired consciousness level. I believe he is slowly coming out of his coma but what he will be left with is still something we can’t really speculate on right now. I would like to recommend that he start with physical therapy and limited occupational therapy as soon as he starts becoming more responsive to commands.”

“When do you see that happening?” AJ questioned quietly.

“Well, if we keep on working with talking to Nick, I think it would happen sooner than expected.”

“Why do you shout at him when you talk to him? He’s not deaf,” AJ asked.

“Auditory nerves can be affected from a coma and the patient needs strong stimuli. So, in Nick’s case you can only get response from him when you are looking directly at him and talking loudly and slowly.”

AJ paled. “So you’re saying he’s deaf now?”

Dr. Garcia shook her head. “No, no, absolutely not! You just have to speak louder to grab his attention. He’s not focused on soft noises or stimuli. You’re just going to have to work for response like you would an infant. What we’re dealing with is that Nick is now something similar to a baby. He’s unaware of himself including anyone that talks to him. You’re there with him when you’re facing him but once you leave, you’re gone. He does not have any memory of you being their two seconds before that.”

AJ’s heart was filling with guilt. “So he’s never going to be the same?”

The doctor shook her head. “I wish I knew whats down the road for Nick. We just have to take this one day at a time. He needs your support and encouragement.”

“Can you help us? I mean, can you be Nick’s new doctor?” AJ asked.

“I would like to if I could, but unfortunately, you can’t make those decisions for Nick, it has to come from his parents. They’re his legal guardians.”

“I’ll call them right now. I want you to be his doctor. You’ve made more sense than those other quacks that’s taken care of him so far!” AJ stated as he stood up. “I’ll have them fax their permission to the hospital. Who do they need to tell?”

Dr. Garcia mentioned the name of the head of the hospital board of directors and the name of the head of Neurology. AJ penned their names into the palm pilot he pulled from his pants pocket.

“Where does it get faxed?”

“Ask the nurses at the desk,” Brian remarked.

“What do you plan on doing once you get permission to be Nick’s new doctor?” Brian asked.

“Order him moved out of ICU to begin with,” Dr. Garcia replied.

"I'm calling his parents and then I'm calling Kev and Howie. They will be anxious to talk to Nicky," AJ announced.

"Hopefully I'll be seeing you again," Dr. Garcia smiled.

After Brian thanked the woman, she left the room with AJ. Brian was once again alone with Nick. Alone dealing with the many thoughts and the questions of "what if?"