Fallen: A Trauma, a Marriage, and the Transformative Power of Music Read Online Free PDF

There is the initial injury—in Simon’s case, the fall—followed by the tissue damage caused by bleeding, and, finally, the damage caused by the subsequent swelling and by potential chemical changes in the traumatized brain. When Simon fell, he hit and damaged the back left side of his head. Inside the skull, the brain catapulted forward so that both the left and right frontal lobes slammed into the bony wall of the inside of his forehead. The initial impact caused several skull bones to fracture. An arterial bleed in his left temporal lobe caused blood to swell between the tissue of his left hemisphere and the dura; during surgery, this large hematoma, or blood clot, in the left hemisphere was removed, a vent inserted into the brain to drain excess cerebrospinal fluid or blood that might pool and cause an increase of pressure, and a craniectomy performed. Because brains, like lips, will swell.
    “The skull is stored in a fridge,” Dr. Griesdale says. “If he survives, we’ll replace it sometime in the future. But you need to be prepared. The damage to his brain is global; it is a very serious injury. We are going to keep him in a medically induced coma until some of the swelling comes down, but you need to understand, he might not survive the night. He might never wake up. And if he does wake up, he will never exactly be himself again. He will most likely be severely disabled. He will certainly have profound and long-lasting brain injuries. We will be making treatment decisions based on the potential for his quality of life. Also,” he adds, “because of the area of the head injury and the fact that he could not feel his legs, we are worried about his spine, but at this point a possible spinal cord injury is a completely secondary injury. We will do an MRI scan as soon as he is stable.” He takes a deep breath. He’s not done. “There is the possibility of a blood clot forming at the top of the cervical spine.”
    I do not understand the exact significance of this, only that, like everything else, it is not good. A news piece I recently heard on the CBC floats into my mind: the greatest amount of damage to the spinal cord happens during the immediate post-accident swelling. The quicker the intervention, the greater the chance for recovery. I imagine Simon on a ventilator without the use of his arms or legs.
    “The blood clot...,” I say. “Simon wouldn’t want, I mean, if there is a surgical option, he would want to take the risk. For his arms.” I don’t know what I am saying, and a look I identify as pity crosses the doctor’s solemn face. I want to turn away from his firm and unsettling gaze but cannot.
    “A blood clot at the top of the cervical spine will not be life-sustaining,” he says. “Let’s just make it through tonight. You need to be prepared.”
    A brief and terrible pause. I feel resistant, pig-headed, stubborn. As if he intuits how unwilling I am to understand, the doctor repeats his previous prediction: “This is going to get much worse before there is any chance of it getting better.”
    No, I want to say. I want to argue, debate, wrestle, defy this seemingly central point. Nothing can be worse than this. But what do I know? This is a new land. I know nothing.
    “YOU CAN SEE him, but only briefly,” Toni says as she leads me out of the conference room. “There are more tests, the MRI ...” Her voice trails off as we arrive at the sliding glass door where I stood—what, twenty minutes, an hour, a lifetime ago?—the doctors shouting at Simon to wake up.
    Simon. Oh God, Simon.
    Wake up.
    I cannot take it all in. The machines that breathe and measure and pump and drain. The mad array of tubes—thin, wide, variegated, colored—inserted into his mouth, his skull, his arms, his chest. The bloody yellowish-orange iodine stain that covers the left side of his head, the side where the skull has been removed. His hands. The wide strong fingers that taste, forever, of guitar strings, the