Being with Rachel Karen Brennan, W.W. Norton & Company, Inc. Page 5 of 5

Meanwhile, Rachel’s team of nurses and doctors and medical personnel labored to ensure her survival from one harrowing moment to the next. Rachel’s “team,” as it was euphemistically called, consisted of her nurses, doctors — neurosurgeons, attending and resident — and a social worker who tirelessly negotiated with insurance companies and that bulwark of terror, the hospital billing office.

The only bright light in those days was the discovery that Rachel did have insurance. For the past two years, she’d been living in Colorado, a ski bum, she used to say proudly, who did a variety of menial jobs in exchange for ski passes. Her only real job had come last year, when she was a teaching assistant in a bilingual junior high. She’d quit her job at Basalt Middle School in May, and I was sure her insurance had expired along with it.

But, miracle of miracles, the insurance expired on September 1, which meant we had about a week to file for COBRA and all her expenses would be covered. The caseworker from the insurance company was especially helpful and compassionate and, except for the four-thousand-dollar air-med flight which wiped out my savings, worked hard to get approval for everything Rachel needed.

But the most valuable team members in those days were her regular nurses, those patient, sleep-deprived men and women who sat at the foot of her bed around the clock, monitoring the monitors.

The first days after a brain injury are the most critical — the intercranial pressures can build dangerously and cause even more damage—swelling, bleeding — to the already traumatized brain. Blood pressure can rise, causing a stroke; the heart rate can slow down or speed up, indicating acute distress to the lungs or heart. As it was, Rachel was on a ventilator in those first days — an archaic-looking dun-colored box which, attached to her oxygen, actually forced air into and out of her lungs at a preset rate. It made a sound like a monster in a monster movie, exhaling and inhaling, coming closer and closer. In a week she would “over-breathe” the ventilator, signifying her ability to breathe on her own, and she would be “weaned.”

Around the same time, we signed the release for a tracheostomy, and soon her trachea would be punctured through her neck and outfitted for her breathing apparatus, freeing — if only cosmetically — her mouth and nose. It would make her more comfortable, they told us. The surgeon also made an incision on her belly for the feeding catheter, through which flowed the greenish “nutrients” they gave her in those days. Sans tape and the skinny plastic tubes running into her nose and mouth, we could see her face, the quick flitting beneath her eyelids, her lovely, serious mouth. She was who she always was: Rachel. Of this we were sure.

Excerpted from BEING WITH RACHEL: A Personal Story of Memory and Survival by Karen Brennan. Copyright (c) 2002 by Karen Brennan. Used with permission of the publisher, W.W. Norton & Company, Inc. books.wwnorton.com.

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