The Longest Day by Jody Silvey

Well, I don't say that any more because no day so far has been worse than June 21, 1990; the day my world was turned upside down.

One minute we were five healthy people on vacation walking down the street. Five minutes later at an intersection, three of those five people were dead.

I remember feeling like I was waking up, struggling out of a very deep sleep. I looked to my left to where my daughter, Megan, was sitting in the backseat of the car. Her head was slumped forward and I reached over and raised it to look at her face, which was covered with blood. I remember saying over and over, "Somebody please help Megan." I don't remember feeling any pain from my crushed ulna, fractured pelvis and ribs nor do I remember seeing the other passengers in our car...I just remember Megan's face.

The emergency room experience is, to this day, very blurry for me, with a few exceptions. After being told I was in a car accident I repeatedly asked how Megan was and was told, "She's very critical." I remember asking or stating "But she's alive?" because I needed that confirmation and was told, "Yes, but she's very critical."

I was in a curtained cubicle being examined for my injuries and overheard someone in the next cubicle speaking about a car wreck in which a little girl had died. I thought they were talking about Megan and I went absolutely crazy...they had to hold me down on the table while they explained it was not Megan who had died, and I didn't ask who had died.

Along with the countless forms for consent I was asked to sign, I was also asked what religion Megan was and I answered "Catholic", as Megan was baptised in that religion, but we do not practice it. I was then asked if I wanted a priest to see her. My first thought was, "Isn't that just like the Catholic religion to go a little overboard...Why would they want to know if I wanted a priest to see Megan?" In my religious training a priest was summoned when someone was dying, so why see Megan? I was not allowing myself to acknowledge the fact that death was indeed so close for my little girl. I learned later that she went into respiratory and cardiac failure in the helicopter in transit and was not expected to live much longer at all.

The truck which broadsided us hit on Megan's side of the car going about 70 mph. What I later learned was the force of the crash from the left caused Megan's brain to slam against the right side of her skull, and then it bounced back and forth, wobbling her brain stem in the process. Our car spun around and slammed into two other cars which compounded the already devastating back and forth motion of Meg's brain. The force also caused her esophagus to swell, which in turn was causing her to slowly suffocate. The EMTs could not intubate her at the scene because of the swollen esophagus and because her teeth were clenched due to brain damage. She was posturing at the scene and had vomit and blood coming from her mouth.

When she got to the ER she was sedated to unclench her teeth,intubated, then she was paralyzed with drugs to prevent any movement which would cause further swelling of the brain. Her abdomen was incised to check for internal bleeding, incisions were made on each side of her chest so that her lungs could be reinflated, massive doses of diuretics for the brain swelling were also administered, she was placed on a ventilator and sent to surgery to have an ICP monitor placed.

No one expected Megan to live. A witness to the crash, a medical student in the hospital where we were taken, later told me I kept asking to go to Megan because I wanted to be there when she woke up. He said it was so sad because no one thought she *would* wake up.

Upon admission to the hospital, Megan was a three on the Glascow Coma Scale. She developed extremely high temperatures, was placed on a cooling bed with cool cloths and fans on her. She also developed bleeding ulcers and phlebitis. Eventually, a jugular port was used to administer meds because her veins were so swollen. We didn't know for at least a week whether or not she would live from minute to minute. The waiting was agonizing...how will I bear this if she dies? How can I possibly live without her? I remember having a dream in which Megan died and saying in my dream, "At least now we know."

I received an excited call in my hospital room from a PICU nurse stating, "Megan has opened her eyes!". My sister wheeled me over to PICU, but I was not greeted with Hollywood's version of a person opening their eyes after a coma. Megan's eyes were opened maybe a forth of an inch...and I believe it was then that I began to realize how little I knew about this thing called traumatic brain injury and I started asking questions.

I learned about the different stages of coma, about how a person can open their eyes and even react to their surroundings and still be in a coma; how their eyes can be open, but they don't track what they see. I also learned that Megan knew who I was on some level and would react to me, usually by calming down or slightly turning her head in the direction of my voice.

I recorded myself and family reading stories to Megan; I also recorded made-up stories which encompassed real people and places in her life and talked about her life up to that point to hopefully get her to remember her past. The nurses would place headphones on Megan and play the tapes when we were away from her bedside.

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It was at times so difficult to talk to her about when we would go home, because I didn't know when that would be or what that would be like. I would say things like, "When we get home and you go back to school..." not knowing if it would ever happen. It was during one of these sessions that I broke down, hobbled out of the PICU and collapsed in tears in the hallway. I was so overwhelmed I didn't know how I would make it...Here I was in a strange city, my daughter horribly injured and my best friend of 21 years dead. How could I possibly bear all this?

After three weeks in PICU, Megan was weaned from the vent and stabilized enough to fly home in an air ambulance accompanied by an RN from the rehabilitation hospital where she was to be placed. We were hugged by the staff and cautioned by the doctors, "Megan may never change. She may be comatose like she is right now for the rest of her life. She may eventually be able to communicate, but she may not. She may walk, but she may not. She needs your love now more than anything. I wish I could tell you more, but with brain injury, we just don't know." How many times in the last 6 1/2 years have I heard those words, "We just don't know." ?

The very serious neurosurgeon also came to see us off. He stated he would understand if I never wanted to see the University of Texas Medical Branch Hospital again, but if I did come back, he would be very interested to do some tests on Megan. I replied that we would be back and that when we did, Megan would do a cartwheel for him in the hallway if PICU. He looked at me with a kind of you-poor-disillusioned-parent look and said , "Well, we'll see...".

A year later, when we returned for the hearing of the drunk driver who caused the wreck, guess who did a cartwheel in the hallway of PICU? :)

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