PART V: COLLEEN'S ICU INTERLUDE
Immediately after inking my approvals, I called Leslie. "I need you to come," I said. I need you here   plus, if they can't remove the tube, someone else needs to be here with her too."

"I'll leave right away," she said. And she did, picking up Colleen's close friend Pat Larkin, who lives nearby, to make the trip with her down to Baltimore.  

Dr. Mathai called. He said he'd wanted to see Colleen after the procedure but, because it didn't finish until after 7:00, he'd had to go home to babysit his three boys. He listened to my distress. He listened to my anger at our not having been told upfront, even days before the procedure, that general anesthesia was Colleen's only option. She may have decided against the surgery if she'd known, I told him. And now she's in danger of extubation failing and, since her wishes are not to be kept alive on a ventilator, she may die. He listened to all of it. I can't remember all that he said but it helped. And he would see her in the morning.

It was now around 10:00 PM on Monday night. Seventeen hours of unknowing remained.

After speaking with Dr. Mathai, I went back to Colleen's bedside and pretty much stayed there until 7 PM Tuesday night. Her eyes continued to be closed. I told her that I'd spoken with Dr. Mathai and relayed to her the message that he would come by in the morning to see her. 

The new lines had yet to be put in. But what about the dopamine? Colleen's dangerously low blood pressure?

Dr. Tottenham came in and said they were encouraged. That Colleen was responding to the single dosage of dopamine she'd been given, well over an hour ago now. Having to do something more invasive might not be necessary after all. But it was still wait-and-see.

Not long afterward, Colleen opened her eyes fully. She looked more alert. I was encouraged. Not long after that she tried to speak, which was impossible. She hen tried communicating with her hands, which were loosely tied down so she wouldn't intentionally or unintentionally tug at the breathing tube. A nurse and tried to guess what she was trying to tell us. Her frustration visibly mounted. The nurse finally guessed it right--Colleen's hands were cold. Scleroderma gave Raynaud's disease to Colleen two decades ago, which causes her hands to turn blue and to feel extremely cold. Her hands were blue now and obviously painfully cold. The nurse quickly fitted a pair of large down mittens over Col's hands. Colleen looked relieved. The nurse asked her if she'd also like additional warmers inside the gloves. Colleen nodded yes.

Not long afterward, realizing that as hard as we were trying, we weren't going to be able to read her mind, Colleen made a writing gesture with her hand. The nurse scurried for pen and paper. I put the pen in her right hand and propped up a blank piece of paper on a piece of cardboard the nurse had also scavenged.

Colleen scrawled, "What happened? Where am I?"

And so, my eyes looking into hers, I told her everything. That she was now in the ICU and why, that they'd had to use general anesthesia after all and had put in a breathing tube. I soft-pedaled in one area only. I told her that they were going to take the breathing tube out in the morning.  Withheld the doubts about whether they would try to take it out in the morning, about whether they could successfully take it out at all. This lack of full disclosure would have been deemed a "sin of omission" when I was growing up Catholic. To me, in this instance, it was none other than the saintly thing to do. To bring to my sister as much peace as possible as she lay  utterly helpless, unable to speak, and in full knowledge of her hazardous state.

She lay still, taking in what I'd said. She then began to write again. "Is the worst over?" Four words that took my breath away in their poignancy--please say "yes"--and their bravery--but tell me the truth. She looked directly at me and waited for my answer.

"Yes, Colleen, I believe the worst is over. Yes."