Chapter 33: An Honest Assessment

March 7, 2001, Greater Cincinnati, Ohio

🎤 Steve

“How bad?” I asked.

“That’s all I know, Steve; I’m sorry,” Sam Kasan answered.

“I understand. I’m actually in Cincinnati today. Do you know which hospital?”

“Good Samaritan.”

“Who?,” my dad asked.

“OK,” I replied to Sam. “I know where that is. I know Melanie’s parents really well, and given it’s going to take her five hours to get here, I’m going to head over there now.”

“Would you call me and let me know?”

“Yes.”

“Thanks, Steve.”

“You’re welcome, Sam.”

We said ‘goodbye’ and I hung up.

“Frank or Trudy?” Dad asked.

“Frank. That was Melanie’s law partner. He said Frank collapsed at work and was rushed to Good Samaritan. Melanie’s on her way, but it’s going to be hours.”

“I’ll take you,” my dad said. “I know you don’t have a car.”

“Let me tell Kara and Jess. I think I’ll have them go home because they both have to be at work tomorrow. I can take a regular flight back to Chicago tonight or tomorrow.”

“OK.”

I set my plate down and walked over to where my wives were talking with Deborah and Krissy.

“Sam Kassan just called me and said that Frank Spencer collapsed at work and was rushed to Good Samaritan.”

Kara gasped, “NO!”

“I don’t know anything yet, Honey,” I said. “My dad is going to take me over to the hospital. Melanie is on her way, but it’ll be hours before she gets here. I think you two, Stephanie, Eve, and Liz should head home on the plane as planned.”

“Are you sure?” Jessica asked.

I nodded, “Yes. You have an ER shift tomorrow and Kara has her polymer lab. I’ll catch a commercial flight tonight or tomorrow, depending on when Pete gets here. I’m pretty sure he was in Wisconsin today doing a transfer. I can be there for Trudy and Melanie until he does.”

“If you’re sure, Tiger.”

I nodded, “I am. I’ll call and let you know as soon as I know anything.”

“OK. We’ll leave here in about an hour for the airfield.”

I hugged and kissed them both, then found Joyce and told her.

“Oh my God!” she gasped. “Do you want to take the Mercedes?”

“My dad is going with me. He’ll get me to Greater Cincinnati airport for a flight later today or bring me back here for the night if my flight is tomorrow. Basically, I want to be there for Trudy and Melanie until Pete arrives.”

“Call me!”

“I will.”

We hugged, then Dad and I headed for the door, but stopped when Stephanie hurried over and asked what was going on. I told her, and she insisted on joining us. I realized that a protest was useless, and the three of us headed out to my dad’s car. Dad handed me the keys to his new Ford Taurus. He got into the passenger seat and Stephanie into the back seat. Once we were all buckled in, I started the car, put it in ‘Drive’, and pulled away from the curb.

“Just take US 27 south,” Dad said. “That’s the quickest way.”

“Hopple Street exit, right?”

“Yes,” he replied.

“You have no idea what happened?” Stephanie asked.

“Only that Frank collapsed at work. He works in the city, so I’m going to guess someone at his office called Trudy who called Melanie. She knew I was here today, so I’m sure that’s why she asked Sam to call me. Beyond that, the only thing I know is that Pete was in Wisconsin today bringing a federal prisoner from Madison to Chicago.”

My phone rang, and I fished it out of my pocket and handed it to my dad.

“It’s Melanie,” he said, then answered it.

“Hello, Dear. Steve is driving ... Yes ... Do you have an update? ... Of course ... Yes ... See you soon ... Goodbye.”

He closed the phone to disconnect the call.

“She only knows what Sam Kassan told you,” Dad said. “Trudy doesn’t have a mobile phone. Melanie figures that given the distance from Cincinnati, she’ll be here in about four hours, give or take. Once Pete drops off his prisoner, he’ll call Melanie to decide what to do. She knows we’re heading to the hospital and she asked you to take care of her mom.”

“Which is exactly what I intend to do.”

“He’s not that old,” Stephanie said.

“Fifty-six,” I replied. “Trudy is Fifty-three. Remember, she had Melanie when she was fifteen, and Melanie is about a year older than I am.”

“I haven’t seen him in ten years,” Dad said. “But if I recall, he’s very active,”

“I haven’t, either. Trudy once said his religion was golf and he played every Sunday morning and Melanie mentioned a year or two ago that during the Winter he’s been going to one of those indoor driving ranges. I’m pretty sure they have a treadmill, too.”

“You never did take up golf,” Dad observed.

“It’s a great way to ruin a nice walk in the country,” I chuckled. “And you do know that ‘golf’ is a four-letter word and that backwards it’s ‘flog’!”

Dad laughed, “Do you remember Mr. Paul teaching you to play when we lived in Bermuda Dunes?”

I nodded, “I do. That was after the moon landing, so I think it was around 1970, which means I would have been about seven. It just never interested me all that much. I was more into baseball back then - both playing and watching. I remember you used to watch golf tournaments on TV back then, as well as go to each of the courses for the Desert Classic every year.”

“Back when my hips could handle walking those kinds of distances.”

“I barely remember Tucson,” Stephanie said. “Just a vague memory of the pool in the backyard and the flash floods which ran down the streets.”

“I remember the Baskin-Robbins on University Avenue,” I replied. “One Saturday afternoon I tasted all 31 flavors, plus the ‘standard’ Vanilla, Chocolate, and Strawberry.”

“I guess your sugar intolerance hadn’t kicked in,” she replied.

“Who knows. I was pretty emotional and volatile, which I always chalked up to Mom. It’s possible that my physiological problems were part of it. There is a suggestion that the large amounts of soda I drank were trying to make up for my naturally low blood sugar, and it makes some sense because I have vague memories of being really active but also feeling lethargic. The thing is, that’s common with kids, especially when puberty starts, so who knows?”

“I don’t know that you’ll ever be able to untangle your childhood situation,” Dad said. “I just wish I’d done a few things differently.”

“Hindsight is 20/20,” I said. “Decisions we make often look unwise years later. But if we get hung up on them, we get stuck in the past and can’t move forward. I spent twenty years seeing Doctor Mercer to help me move forward. Japan was a watershed, and my need for therapy was seriously diminished after that.”

“Says you!” Stephanie teased. “There’s no cure for having a ‘Y’ chromosome!”

“Girls only function because of their ‘X’ redundancy,” I chuckled. “Men have genetic diversity!”

“So you’re saying women are all women and men are half women?”

“Funny thing,” Dad said to me with a grin. “Both our daughters sound EXACTLY the same!”

“If there is a god,” I chuckled, “my first question is going to be what it was that I’d done to deserve a sister like Stephanie AND a daughter like Birgit!”

“You love both of us!” my sister declared.

I laughed, “Which is exactly what Birgit says, usually resulting in one of her moms or me saying that’s the only reason she’s made it to age twelve! And if I find out that YOU are behind her behavior, rather than Penny or Katy...”

Stephanie smirked, then stuck her tongue out at me.

“They’re both quite the handful,” Dad said.

“No kidding!” I agreed.

I navigated the last few turns and pulled into the parking lot near the Good Samaritan Emergency Room. When I had parked and shut off the engine, the three of us got out of the car. I locked the doors and we headed into the ER. I saw a distraught Trudy sitting alone in a chair near the far wall and hurried over to her.

“Hi, Trudy,” I said holding out my arms.

She stood up and I hugged her.

“Melanie said you were in Ohio,” she said.

“How is he?”

“They took him for CT,” she said. “That’s all I know.”

“What happened?”

“He was disoriented and went to sit down but collapsed to the floor. His secretary called the paramedics, and then me. I was home, so I called Melanie then jumped in the car and drove here.”

“Have you seen him?”

“No, he went for the scan before I arrived.”

“OK. I’ll be here at least until Melanie and Pete arrive. Melanie said Pete will head here as soon as he drops his prisoner in Chicago.”

“Thanks.”

My dad and Stephanie both greeted her and then the four of us sat down. I pulled out my mobile phone and called Jessica. I told her what I knew and she began asking questions, so I got up and walked a bit away.

“Honestly, Babe, that’s all I know,” I said.

“When the doctor comes to talk to Trudy, you should ask a couple of questions.”

“What are you thinking?”

“Well, if he presented with those symptoms with no history, I’d guess a mild stroke or a subarachnoid hemorrhage.”

“Bleeding in the brain, right?”

“Yes. It could be from anything, including bumping his head to an aneurysm, or as I said before, a stroke. When the doctor comes, ask why they did the CT and then ask the doctor for a ‘Hunt and Hess scale’ grading. It’s one to five, with one being relatively minor to five being severe. From what you said, he came in as a ‘three’ or ‘four’.”

“Prognosis?” I asked.

“I obviously haven’t examined him, but mortality is north of two-thirds for patients graded ‘five’. Mortality decreases significantly as you go down the grading scale.”

“What’s the treatment?”

“If it’s a mild stroke, blood thinners are the first-line treatment. If it’s from a bump on the head, then it’s likely a mild concussion. Think about your post-concussion syndrome.”

“I’d rather not,” I replied. “But I get it. And if it’s an aneurysm, then what?”

“It depends, but mostly it’s surgical options.”

“OK. I’ll ask once the doctor explains things.”

“You know how it works, Tiger. It’ll be vague and non-committal unless you ask very specific questions and push to get a very specific answer.”

“I’ll ask. You’re leaving for the airport soon, right?”

“Yes.”

“I’ll call and let you know what I find out. If you don’t hear from me before you board the plane, call as soon as you get to Chicago.”

“OK. Love you, Tiger.”

“Love you, too, Jess. Let Kara know I love her, too.”

We said ‘goodbye’ and I hung up, then dialed Molly’s mobile number. She answered and I explained I wouldn’t be home. She asked if I needed her to cover Thursday. If I did, she’d send Brett home in the morning and stay at the house. I replied that I felt that was probably best, thanked her, then hung up. My third call was to Penny to let her know I wouldn’t be at the house in the morning. I gave her a brief update, then ended the call. My fourth call was to Jennifer.

“NO!” she gasped when I told her where I was and what had happened. “Call me the SECOND you know anything!”

“I will,” I said. “Stephanie and my dad are here with me. I’ll stay until Pete gets here. I don’t want to leave Melanie or her mom without some kind of support.”

“Don’t even think that!” Jennifer said.

“Even if he’s just hospitalized, they’ll need someone.”

“True,” Jennifer agreed. “Tell Trudy and Melanie I love them.”

“Will do.”

We said ‘goodbye’ and I hung up and went back to sit with Trudy, Dad, and Stephanie. It was nearly an hour later when a doctor came into the waiting room and called out Trudy’s name. She and I got up and walked over to the doctor who led us to a small consultation room. He shut the door and the three of us sat down - Trudy and I on a couch and the doctor on a chair facing the couch.

“I’m Doctor Jerome Katz,” he said. “I’m an Attending neurologist called to consult on your husband’s case.”

“Can I see him?” Trudy asked.

“Not immediately. He’s in the ICU, on a ventilator...”

“What happened?” Trudy asked, interrupting him.

“He reported a severe headache, said he felt sick to his stomach, then became dizzy. He attempted to sit down and missed the chair, collapsing to the floor. The paramedics were called and he was brought here. We evaluated him in the ER, then took him for a CT scan which showed some bleeding in his brain.”

“A subarachnoid hemorrhage?” I asked.

“Why, yes,” Doctor Katz replied, looking intensely at me. “Hang on; do I know you?”

“I’m not sure. I’ve met so many doctors over the years, that I can’t say. Would you tell me your Hunt and Hess grading, please?”

“It’s five, but how do you know about that?” he asked, surprised.

“My wife is an Attending trauma surgeon and my father-in-law is Chief of Emergency Medicine, both at UofC Hospital in Chicago.”

His eyes widened in recognition, “You’re married to Jessica Wilton. You and I met at Doctor Barton’s house about sixteen years ago, when Jessica and I were second-year med students.”

“Jerome!” I replied, remembering that reception. “I should have known. Sorry.”

He smiled, “Don’t be. I had no beard and a head full of hair then; now I have a full beard and no hair!”

“So, can we dispense with the usual embroidery, please?” I asked. “Trudy and Frank are two of my oldest and dearest friends, and they were like surrogate parents when I was in Junior High and High School.”

He nodded, “Trudy, your husband suffered a ruptured aneurysm. There is significant bleeding in his brain and the head of neurosurgery is examining him now to decide on the best course of treatment.”

“An aneurysm?!” Trudy gasped. “But he’s in perfect health! He doesn’t smoke and rarely drinks, and he’s very active!”

“They’re often genetic,” Doctor Katz said. “Is there any family history?”

“Not that I know of,” Trudy replied. “His dad is still alive, and so is his older brother. Can you fix it?”

“We don’t know just yet,” he said.

Trudy put her head in her hands and began crying. I put my arm around her and exchanged a look with Jerome which told me that the answer to the question was very likely ‘no’, or at least not in time. I didn’t know the pathophysiology, but I was sure that if they couldn’t control the bleeding, there was no hope, and that if the location wasn’t easily accessible to a craniotomy, there was little that could be done surgically.

“When will you know?” I asked.

“Once Doctor Kurtis finishes his evaluation.”

“Thanks, Doctor. Does the hospital have a Catholic chaplain?”

“Yes.”

“Would you call him so he can pray with Trudy, please?”

“Yes, of course. You can stay here and I’ll have him paged.”

“Thanks. Doctor Katz.”

“You’re welcome. Say ‘hello’ to Jessica and Doctor Barton, if you would.”

“I will.”

“I’ll be back as soon as I know anything more.”

“Thanks.”

He left and Trudy sagged against me. I held her as she cried for a couple of minutes, then opened her purse and took out some tissues to dry her tears and blow her nose.

“I should call Melanie,” she said.

“Use my cell phone,” I replied. “If it’s OK, I’ll go tell my dad and Stephanie, and I’ll come right back.”

“Yes, go on.”

I handed her my cell phone then went out to where my dad and sister were sitting.

“How is he, Son?” Dad asked.

I shook my head, “Not good. Based on what Jess told me, and what the doctor said, I’d say there’s a very good chance he’s not going to make it. Squirt, can I borrow your phone? Trudy has mine so she can call Melanie.”

“You’re sure Trudy is OK?” Dad asked.

I nodded, “I know the code, so I know the situation. I think Trudy has far more hope than she should, but I’ll let that go for the moment.”

Stephanie handed me her phone and I dialed Jessica’s number. It went to voicemail so I simply asked her to call me, then handed the phone back to Stephanie.

“I’m guessing they’re in the air; the phone went to voicemail.”

“What did they tell you?” Dad asked.

“The CT showed a ruptured aneurysm. Frank is unconscious and according to the doctor, at the wrong end of the scale of severity, to the point where he’s very likely to die from the bleeding on his brain. It’ll take a surgical repair, if one can be done.”

“When will they know?”

“As soon as the chief neurosurgeon finishes his evaluation. Let me go back to sit with Trudy. The chaplain is going to come to pray with her.”

My dad nodded and I went back into the consultation room where Trudy was just finishing her call with Melanie. She hung up and handed me the phone just as a Roman Catholic priest came into the room.

“Mrs. Trudy Spencer?” he asked with an obvious Irish accent.

“Yes,” Trudy replied.

“Father O’Rourke,” he said. “I understand your husband is in the ICU?”

“Yes.”

“Let’s pray for him, and then we can talk,” Father O’Rourke said.

“I’ll give you some privacy, if you want,” I said.

“No, stay, please,” Trudy requested. “Father, this is Steve Adams, a close family friend. My daughter is on her way here from Chicago.”

“Where is she, Trudy?” I asked.

“About an hour from Indianapolis.”

Which meant just under three hours before she’d arrive.

“Are you Catholic, Steve?” Father O’Rourke asked.

“Severely lapsed,” I replied. “But I remember the prayers. Trudy is faithful.”

“May I sit?” he asked.

“Yes, of course,” Trudy replied.

“Let us pray,” Father O’Rourke said.

Trudy took my hand, and I sat quietly as the priest said several prayers for the sick, as well as the Lord’s Prayer and the Angelus, the responses to which came surprisingly easy, despite not having said them in more than twenty years. We had just finished when Doctor Katz returned.

“Your husband is being taken to surgery,” he said. “I’ll need you to sign the consent form, please.”

Trudy looked it over, showed it to me, and I nodded. She signed it, then handed it back.