survives, the nature of these injuries will lead to certain outcomes, and it’s best to be realistic about them. Given the severity and height of the injury—which is to say its proximity to the base of the brain stem and the trauma sustained by the cerebral cortex—should Alex survive, normal brain function cannot be reasonably expected. Alex will never breathe on his own, and below the neck he will not move on his own. This injury will preclude Alex from swallowing food. He is presently receiving fluids intravenously, but if he survives, we will have to install a gastronomy tube, or G-tube, so he can receive nutrition directly into his stomach. And, finally, if he does survive, he will never be able to speak. I understand these are difficult things to hear. Truly I am sorry.”
G-tube, no normal brain function, paralyzed —my eyes fell to the floor, fixed in stunned disbelief. It was all so overwhelming it would have to be sifted through piece by piece, but the doctor had spoken. We would have to deal with it. The information was so horrific and the scale of it so massive that my mind went into numbed acceptance. I’d think more coherently about the details later.
Beth’s experience, informed by Dave in the parking lot, was completely different. She wasn’t having any of it. I was still looking at the floor when she spoke. Looking directly into the doctor’s eyes, she confidently spoke three simple words: “You are wrong.”
I inhaled sharply, thoroughly embarrassed. This doctor was the head of a team of top-notch surgeons, all of whom had reviewed Alex’s case. We were under the care of one of the best children’s trauma units in the country. Who was she to question them? I placed a hand on her arm, trying to get her to stop talking. She needed to sit back and accept reality, as I was doing. Beth pulled away from my touch. She had no intention of backing down.
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+ + + Trying to take in the scope of Alex’s injury was overwhelming. Like looking over the rail at the Grand Canyon, your mind is incapable of grasping the enormity of what you see. It wasn’t explained to us until much later why, medically speaking, it was so unlikely that Alex would survive. He had suffered an internal decapitation—his skull was detached from his spinal column. Skin, muscle, and ligaments were holding his head on his body, but his spinal cord tendon sheath was severed. Months later we received an X-ray from a medical professional taken more than an hour after the car accident. The X-ray was of the bottom portion of Alex’s skull and the top portion of his spinal cord. The X-ray clearly reveals Alex’s vertebrae detached from his head. Not only was there no mention of this situation to either my wife or me, but there has never been a medical procedure to reattach his skull to his spinal column.
Kevin Malarkey
+ + +
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“Alex is going to be fine. His health will be fully restored, and his story is going to have a national impact, bringing hope to thousands of people.”
Okay , I told myself, she is totally losing it . I looked at the doctor, confident of what he was thinking, although I have to hand it to him—he listened to Beth with an earnest concern, nodding his head sympathetically. There was not one thought in my mind about Alex helping others. I just wanted my boy to be okay. I wanted my own guilt to dissipate. I wanted my son to regain consciousness long enough for me to ask his forgiveness—a conversation I had already played over in my mind a thousand times since the accident a few hours earlier.
But Beth was just getting started.
“I know you don’t believe me, but he is going to get better, and I mean completely healthy.”
I sat back, helpless to stop the drama. The good doctor continued to nod respectfully. I was sure I could read his mind: Another poor woman in the grips of an irrational outburst brought on by shocking news she doesn’t want to be true . . . seen it thousands of times. It’s