Back in Kansas, Hope continued to pace her kitchen worriedly. “What’s going on with Victor and why haven’t I heard anything? Victoria said she’d call when she had news, so why haven’t I heard from her? What’s taking so long? Is it Victor? Or is Nikki in the hospital? Why hasn’t anybody called me yet? What could be going on? ” “It can’t be his heart, I would’ve heard from Victoria or Nicholas or someone by now! He has to be okay, he has to be!”
With her palms sweating and her heart pounding, she picked up the phone and called Douglas. “Hello?”
“Hi Douglas, it’s me. Have you heard from Victoria or Victor by any chance?” Hope asked, desperately hoping he had.
“Hope, what a pleasant surprise! Douglas asked pleasantly, surprised to hear from her.
“No, I’m sorry, I haven’t. Hope, is anything wrong?” he asked, starting to worry.
“I really hope not, but honestly, I’m starting to get really worried. Douglas I haven’t heard from Victoria since she called hours ago. I’m scared, what if something’s happened to Victor?”
“Douglas, I don’t know how much you know about what’s been going on with Victor, but his health wasn’t good before this and we haven’t heard from him or anybody else for that matter. What could be going on? Why haven’t we heard anything? What could be wrong with Victor?”
“I know everything, Hope. Victor told me.”
“Then how can you be this calm? Haven’t you spoken to Victoria? She can’t find her parents anywhere. If something’s happened to Victor–”she stopped short as tears welled in her eyes and forced herself to take a deep breath.
“Yes, but surely if something were wrong, we would have heard something by now!” Douglas reasoned firmly, trying to reassure her.
“Not necessarily. If it’s his heart, if something’s happened to him and he’s in the hospital, they wouldn’t necessarily be focussed on anything else but making sure he’s okay and they should be focussed on that, damn it Douglas, I just wish we knew what was going on and where Victor and Nikki are! I wish we at least had a clue about what’s going on!” Although Hope tried her best, she couldn’t disguise the fear slipping into her voice little by little, much like it slipped down her spine.
“Hope, try and stay calm. I’m sure we’ll hear something soon. Just try and stay calm.” Douglas reasoned, trying to allay her fears and his own.
“I will, thank you Douglas. Call me if you hear anything, please.” Hope begged, her voice holding the same note of urgency, the same barely controlled fear and undisguised worry it had held throughout their conversation.
“I will. You do the same.” He reassured her before hanging up and saying a prayer that he was right and everything would be alright in the end.
“Mom? Any luck?” Victor Jr. asked as he made his way downstairs slowly, his legs feeling like lead weights before he slumped into a chair beside his mother at the kitchen table.
“No, what about on your end?” Hope asked tiredly, trying with everything in her to cling to the few remaining shreds of hope she still had that she was wrong and that despite what her every instinct told her the man she once loved more than anything would be okay.
“Nothing, I’ve checked all the articles and web sites I could find online and nothing! Not a single clue about what could be going on with him! Damn it! What the hell’s going on and why haven’t we heard anything!” Victor Jr. hollered as he slammed his fist on the table furious and frustrated, and though he would never have admitted it to anyone, much more afraid than he would have ever let on.
“Sorry.” He mumbled as he realized what he’d said.
“It’s okay.” Hope whispered, her voice choked by tears that were flowing freely from her eyes as she rose from the table and walked outside to stand on the porch.
As the sun shone over the farm, making stacks of hay glint gold in the sunlight and turning pastel, delicate flower petals into vibrant splashes of colour dotting the landscape, Hope stood on her porch, tears slipping silently down her cheeks and whispered in a broken voice, “I don’t want to lose him.”
Not trusting his own voice, as tears welled in his own eyes before silently slipping down his cheeks, Victor Jr. Wrapped his arms around his mother and offered what little comfort he could to the woman who had always given him so much more.
Back at the hospital, it didn’t take the three doctors long to find Nikki and Casey sitting in the waiting room quietly talking.
Having had a good long nap, Nikki quickly got to her feet as she spotted them walking in.
“Nikki, I’m sorry we haven’t been to see you in awhile.” Dr. Thorton spoke first, her voice quiet and apologetic.
“That’s alright. How’s Victor? How’s my husband?” Nikki asked anxiously.
“Mrs. Newman, I’m sorry to have to tell you this. We did everything we could, but your husband has slipped into a coma.” Dr. Hoffman tried his best to tell her what had happened as gently as she could.
“What? What are you talking about? Who are you and how do you know anything about my husband?!” Nikki shot back angrily, reeling from what she’d just been told. She stood in front of the three doctors and eyed each carefully.
Although Dr. Cornwell and Dr. Thorton had over fifty years of experience between them, the baby-faced doctor standing in front of her seemed barely old enough to be an inturn, and certainly not old enough to be a cardiologist. His jet black hair had a healthy shine and his teeth were pearly white. His smile was warm and sympathetic.
Dr. Cornwell stood beside him, with her short greying hair perfectly styled to fit her practicality and her warm hazel eyes matched her personality-quiet and understanding. She was happily married, and had been for the past forty-five years, and her face held a few wrinkles. But, beneath all that, there was a basic kindness, a gentleness about her that Nikki couldn’t help but find comforting.
Dr. Thorton had none of the life experience Dr. Cornwell had, but she too had a basic kindness and an understanding that Nikki found herself drawn to, despite her first impression. The woman, who certainly did not look her age; fifty-five; was surprisingly thin. Her eyes were a soft blue, her smile warm and calm.
Dr. Cornwell told her, “This is Dr. Hoffman. He’s a cardiologist we’ve brought in to consult.”
“I’m from John’s Hopkins,” he said, hoping that would put her at ease.
“Pleased to meet you.” Nikki’s voice was tight and tense as she eyed them impatiently. “What’s going on with Victor? How is he? What happened?”
“Mrs. Newman, I think you should sit down,” Dr. Thorton told her quietly.
After exchanging puzzled and tense, irritated glances with them, Nikki did as she was told.
“Nikki, before we go any further, you need to realize something. We’ve done everything we can for Victor at this point.” Dr. Cornwell said quietly, regretfully.
“Just get to the point!” Nikki snapped angrily, impatiently.
“Mrs. Newman, I’m afraid your husband has slipped into a coma.” Dr. Hoffman continued quietly.
“What?” Nikki’s voice was so quiet, so small that it was barely audible in the small waiting room. “He can’t be! He can’t be in a coma! He was just brought out of surgery for God’s sake!”
“Mrs. Newman, it happened very quickly. We’re not even sure what happened at this point.” Dr. Thorton told her solemnly.
“Believe me, Nikki, we wish we had better news for you. We wish we could tell you this is just some mistake or a joke. We wish we could do that, but we can’t.” Dr. Cornwell’s heart went out to Nikki as she sat there completely still, save the tears swimming in her eyes, trying valiantly to take in all she’d been told.
“Mrs. Newman, I’m sorry, but under the circumstances-” Dr Thorton faltered, struggling to find the words she needed to tell her she was dangerously close to losing her husband. “I’m sorry, Mrs. Newman, but Victor’s chances are not good. Too much damage has been done, between the heart attack and the stroke, now the coma, Mrs. Newman, it’s doubtful he’ll ever come out of it. If he does, it’ll be a miracle. He’s just too weak, at this point, there doesn’t seem to be much hope. I’m sorry, but we just don’t see him coming out of this.”
“What are you trying to tell me?” Nikki asked, her voice dangerously low. Although her voice trembled a little, there was no mistaking the light of challenge, the light of determination shining in her eyes.
“Nikki, we need to be honest with you. Victor’s chances of surviving this, his chances of coming out of this aren’t good. They’re next to nothing. I’m sorry. I’m very sorry.” Dr. Cornwell told her softly.
“That’s it, you’re just giving up? Just like that, you’re giving up?” Nikki asked furious as she shot to her feet.
“Mrs. Newman, we’ve done everything we can. At this point, our best advice is to at least consider discontinuing life support. He’s been put on it because of all the damage done by the heart attack and the stroke. But, frankly, I’m not sure how much that will help him. He’s had a lot of damage done, Mrs. Newman.” Dr. Hoffman’s heart went out to her as he stood there studying her and waiting for what would undoubtedly be a very violent reaction.
“You want me to pull the plug? You want me to pull the plug on my husband?! Get out! Get the hell out; all of you!” Nikki shot back indignantly, fuming!
“Mrs. Newman, it’s one option. We’re not suggesting you do it immediately, but it may come to that.” Dr. Hoffman tried to reason with her.
“Not on your life! Get out all of you! I don’t want to hear this garbage! GET OUT!”
“Nikki, calm down.” Casey tried to keep her calm.
“No! Listen and listen well-I will not even entertain the idea! Under no circumstances am I going to pull the plug on my husband; end of discussion!” The banked fury in her eyes was straining to be free.
“Mrs. Newman, perhaps you should think about this a little longer, we could give you more information, talk to you a little more.” Dr. Hoffman tried to be helpful.
“You want to help me, fine! Get out of my sight! I don’t want to see any of you! I don’t want to hear from you! And hear me when I say if any of you dares to do anything close to what you’re suggesting, I’ll sue you for everything you have! I’ll make sure you never get the chance to practice medicine again! Am I making myself clear?” Nikki spat out, her voice ice cold, as were her eyes.
“Mrs. Newman, the heart attack was bad enough, but coupled with the stroke and now the coma, your husband’s body has been all but ravaged. It’s highly unlikely that he can survive this.” Dr. Thorton told her quietly.
“Don’t talk to me about statistics and probability! I know my husband! He’s been beating whatever odds were against him all his life! He’s done it his whole life and this time’s no different! I will not lose my husband, do you hear me? I will not lose him!”
“I know that this is difficult for you, but-” Dr. Hoffman stopped short as she silenced him with a murderous glare.
“With all due respect, Dr. Hoffman, you don’t know a damn thing about what I’m going through, so don’t even try to act like you do!”
“Nikki, you know Victor wouldn’t want to be hooked up to machines for the rest of his life. That’s not the way he wants to live.” Dr. Cornwell reasoned softly.
“Let’s get one thing straight right here, right now. I know my husband better than the three of you put together! I’m the one who’s stood by him for the past twenty-six years so don’t you go telling me what Victor wants! I know damn well what he wants! Now get out of my sight! Get out before I do something I’ll regret!” Nikki all but yelled, barely resisting the urge to start throwing whatever she could get her hands on!
Wordlessly, silently and sombrely they left.
“Nikki, are you okay?” Casey asked hesitantly.
“No, I’m not okay! They think they know Victor better than I do!” She spat indignantly.
“They don’t know anything! I know him, Casey, I know my husband, not them! They know facts and figures, stats and charts, test results and…”Her voice trailed off as it was choked by tears. Unable to find her voice, she shook her head silently, defeatedly and paced to the window.
“I think it’s time to tell Nicholas and Victoria.” Casey told her as she followed her.
“No! I am not going to do that! I’m not going to worry them!” Nikki’s tone brooked no argument as she whirled around to face her sister.
“Nikki, they haven’t heard from either of you in hours-they’re already worried! You know they are! How could they not be under the circumstances I don’t have to tell you that! This shouldn’t come as some big news to you, it surely you’ve though about it” Casey did her best to reason with her sister.
“I’ve thought about nothing else, nothing! Casey, don’t push me on this!” Nikki warned, as fire burned in her eyes.
“Fine! You want to wait, fine! But, your children, your family will be the ones to pay the price! Think about that, Nikki! Think long and hard before you go doing anything you’ll regret!” Casey warned as she glared at her before storming out and straight to her office.
Once she was gone, Nikki said to herself, her voice small and fearful, but not without determination, “Casey just doesn’t get it. She’s trying to understand, but she doesn’t. It’s my job to make sure this family stays together, to make sure we stay strong. That’s what I’m doing, that’s what I have to do! Victor will be okay, he’ll be just fine; he has to be!”
With a tired sigh, Nikki picked up the first binder and continued with the reading she’d been doing. “Causes of strokes/Types of Strokes: There are two main kinds of strokes: strokes caused by blood clots and those caused by bleeding.
Strokes caused by blood clots-As people get older, a waxy plaque can build up along the inside of the arteries which feed the brain. The thicker the plaque grows, the less room there is for blood to flow. Smoking, diabetes, high blood pressure, and high cholesterol can cause this buildup. At times, a blood clot may plug an artery narrowed with plaque. This can cut off blood flow. A blood clot which causes a stroke can form in an artery where there is a lot of plaque. Or one may form somewhere else in the body. At times, a blood clot forms in the heart and makes its way to the brain. If someone has a stroke caused by a blood clot, here are some terms the doctor may use: Ischemic– This is a term used to describe a type of stroke in which a blood clot blocks an artery, cutting off blood flow. A blood clot in an artery in the brain, or in an artery supplying blood to the brain, can bring on a stroke. A blood clot in an artery supplying the heart may cause a heart attack.
Atherosclerosis–refers to the buildup of a thick, rough plaque on the inside walls of an artery. The inside of the artery is narrowed and less blood can flow through.
Atherothrombosis–refers to when a blood clot forms over built up plaque (atherosclerosis) inside an artery. The blood clot is called a thrombus and the thick, rough, fatty plaque is called atheroma (plaque. If the plaque’s also present in an individual’s heart, he or she may be at risk of having a heart attack.”
Frustrated, Nikki grumbled, “Victor, damn it! Why didn’t you listen to me! You knew I was worried, you knew you were in trouble and under stress, you knew your diet wasn’t what it should’ve been! Why didn’t you just listen to me?”
Taking deep breaths and trying her best to calm down, Nikki continued. “Strokes caused by bleeding–Strokes may also be caused by breaks in blood vessels in the brain. When the blood vessel bursts, blood rushes into the brain and damages it. This type of stroke is named a haemorrhagic stroke. High blood pressure can cause this kind of bleeding stroke.
The following are some terms a doctor might use if someone has had a haemorrhagic stroke: Aneurysm– is when a blood vessel wall is weak and balloons out. These can be caused by a disease or injury to a blood vessel, or people may be bon with them. If the aneurysm bursts, it may cause a haemorrhagic stroke.
Intra cerebral haemorrhage–a stroke caused when an artery in the brain breaks or ruptures and blood enters the brain.
Subarachnoid haemorrhage–a stroke brought on by bleeding on the surface of the brain, in the area between the brain and the skull. The majority of strokes are caused by blood clots or bleeding. In a few individuals, blood flow through an artery can be interrupted by a growth like a tumour, an infection or brain swelling also known as edema.”
‘It’s a wonder doctors don’t get tongue-tied when they’re talking to patients or doing and reading all this research’ Nikki thought to herself with a small shake of her head.
“Each stroke is different. How people recover from one depends on several factors. These include how much of the brain was damaged, what portions of brrain were damaged and an individual’s health prior to the stroke. Work done with a rehabilitation team and support of family and loved ones are also critical to recovery.”
“Stroke effects: Strokes damages the brain and cause sudden loss of brain function. Because the brain controls everything people say, do and think, a stroke can have many different effects.”
“Really? Tell me something I don’t know!” Nikki snapped, slamming the binder shut and throwing it on the couch beside her before pacing to the window to stare out it blindly as hurt, furious tears fell from her eyes.
“Nikki,” Casey spoke hesitantly as she entered the waiting room.
“Casey,” Nikki said, unable to find the words she needed to tell her sister just how sorry she was.
“I’m sorry, I said some things I shouldn’t have.”
“So did I. I’m sorry. I’m just so frustrated and angry. None of this should have happened! And the last thing I want is to have to tell Nicholas and Victoria their father might not make it. I don’t know what to do Casey, how do I tell them? How do tell them?”
Unable to stand seeing her sister in so much pain, Casey walked up to her and wrapped her arms around her, trying to offer whatever comfort she could.
After hours spent pacing the waiting room without news, Nikki sent Casey to find Dr. Cornwell, Dr. Thorton and Dr. Hoffman.
A few minutes later, Casey returned with all three doctors. “Thank you for coming,” Nikki said as she eyed them intently, hoping to get some answers.
“Of course. What can we do for you, Nikki?” Dr. Cornwell spoke first.
“I have a few questions I want answered.”
“Such as?” Dr. Thorton asked carefully.
“There’s nothing more you can do for him, nothing? You’re absolutely sure you can’t do anything more for Victor?”
“No, unfortunately we did everything we could to treat you husband after the stroke, as for his heart, as we said, the damage was too extensive. We can’t do anything more in terms of repairing it, that was an option before he had the heart attack, but it’s no longer the case, I’m afraid. I’m sorry. As for the stroke, the only treatment left would be physiotherapy, speech therapy and other therapies, but we can’t start that until he wakes up, until we find out exactly how the stroke has affected him. We need to find out what parts of the brain were affected and how before we can decide on a course of treatment. But, as we said, the chances of him coming out of it are slim to none.”
Nikki listened silently, intently and then asked, “You said he had a heart attack and then stroke while he was on the operating table, how? How did it happen? How could this have happened?”
“After looking at the tests we’ve done so far, we’re sure that some type of argument or other stressful event brought on the hart attack.” Dr. Cornwell spoke first, glad to give her at least some of the answers she was so intent on finding.
“As far as what brought on the stroke, we’re not sure yet. We’re still running tests. We do know it was caused by a massive haemorrhage and we treated him for it, we gave him medication to help his blood clot better and we’re watching him closely. We gave him a blood transfusion as well. Unfortunately though , we don’t know exactly why the bleeding happened in the first place. We know that arteries in and around his brain ruptured, causing massive bleeding, but unfortunately, we don’t know anything else. We’re sorry, Nikki. We also have a general idea what areas were affected, but we’re not a hundred percent sure yet. That’s why we’re still doing the tests.” Dr. Thorton replied, disappointed and frustrated she couldn’t be of more help to a woman who was already dealing with so much.
“Damn it! I tried to tell him that he needed to cut down on work, but did he listen? No, of course not, that would have made sense! Why didn’t he listen to me? Why didn’t I make him listen to me?! Now what? How serious is it? What do we do, how do we handle this? What can we do to fix this? There has to be something!” Nikki fired question after question at them, hoping to get at least some answers.
Then what Dr. Cornwell said about an argument possibly causing Victor’s heart attack finally registered. “What could an argument have to do with this?”
Sitting across from her, Dr. Cornwell replied sympathetically. “Don’t blame yourself. Victor knew the risks he was taking, he made his own decisions in spite of those risks.”
“Depending on how heated the argument was, it could have triggered the heart attack.” Dr. Cornwell answered honestly.
“Alright, I asked this before, I’ll ask you again, what can we do to fix this? There has to be something we can do!”
“Mrs. Newman, I’m afraid that, at this point, the damage from the haemorrhages and the heart attack, combined with Mr. Newman having waited so long before finally deciding to do something about it is just too severe. I’m afraid that, we’ve done everything we can at this point, the only thing left to do is to perform a heart transplant. I’m afraid it’s your husband’s best option, his only option really. I’m truly sorry.”
Reeling from what she’s just heard, Nikki replied, her voice shaky but determined, “What? What did you say? You want to do a heart transplant? That’s really our only option here? With all due respect, Dr. Thorton, save the apology. My husband’s not dead yet! And if I have anything to do with it, he’ll be just fine. You just do whatever tests you need to do to find out what happened and fix it. Let me worry about the rest!”
Regretfully, solemnly, Dr. Thorton replied, “I’m afraid so. Mrs. Newman, nobody has given up on him yet and we won’t.”
“Good. Now, what about the stroke? What could have caused it?” Nikki asked as she tried to remain calm and focus on what the doctors were saying. “The more information I have, the better Victor’s chances are of coming out of this. I have to focus on that right now. I can’t let anything stand in the way of that!” she told herself sternly, hoping that she wasn’t grasping at the last ray of hope in what seemed like a completely hopeless situation.
Dr. Thorton spoke up first. “The tests will tell us a lot about what caused the stroke and its effects and then we can go from there.”
“How much damage was done? How severe was the stroke? You must at least know that.”
“We won’t know for sure until he wakes up how severe the stroke was and the extent of the damage.” “Perfect, just perfect! In other words, we know absolutely nothing about what’s going on with my husband!” Nikki snapped infuriated.
“Mrs. Newman, we don’t know much of anything for now. But, we’ll do everything we can for your husband. I promise we’ll do everything we can to make sure he comes out of this okay.” Dr. Thorton replied, trying her best to offer at least some comfort.
“Um, Nikki, it’s our responsibility to notify the next of kin, I know that Nicholas and Victoria would want to know about this. Do you have any idea where we can reach them to make sure they come here so we can tell them what’s happened?” Dr. Cornwell asked hesitantly.
As the colour drained from her face and her eyes widened in fear, Nikki whispered, “That won’t be necessary, I’ll tell them. I’ll tell my children.”
“Alright, if you’re sure.”
Without looking up at any of them, Nikki nodded imperceptibly and tried to stem the flow of angry, bitter tears.
“Don’t give up, Mrs. Newman. We’re not.” Dr. Thorton told her firmly.
“Dr. Thorton’s right. I’ve known Victor a long time and it’ll take more than heart problems, even problems as severe as these to stop him. Don’t give up just yet.” Dr. Cornwell agreed as they left Nikki to herself to try and figure out just how she was going to break the news to her two oldest children. “Believe me, I’m not. Thank you.”
Satisfied that Nikki would be fine, Dr. Cornwell, Dr. Hoffman and Dr. Thorton left her alone with her thoughts.