A/N: I wasn't going to put a note here, but… med speak ahead! I also engaged in a practice called infodumping. This basically means I wrote a thousand words worth of description about said med speak, even though my readers likely aren't all that interested in it. :P If you get excessively bored with hearing someone drone on and on and on and on through medical descriptions with little to no emotion, this chapter might not be for you. But at the same time, it's got good information, so I don't want to tell you not to read it.
Also, sorry I'm late. I've been super busy with school and volunteering and cooking myself three meals a day for the first time. Hopefully, I won't get behind, and you guys won't have to wait forever for chapters.
Onward ho!
Everyone woke up the next day around 8:30. London, Maya, and Kurt, who had not showered the night before, took turns showering. Even Woody showered. London treated everyone to a late breakfast delivered by room service, but no one was really all that focused on eating. Almost everyone ended up wrapping up their plates and putting them in the fridge only half-eaten.
It was 10:30, and the group was almost ready to leave. Cody walked into his room and grabbed what he had written the night before as the others made sure they had everything they needed, and as he came out the door, he grabbed the unopened letter off the top of the tape box.
"You guys don't have to come," Cody said as he walked to the group by the door, "since they're probably not going to let you in anyway," he finished.
"No, we want to be there," Bailey said.
"Yeah," Maya added, "we wouldn't want to miss out on any news."
Woody and London nodded in agreement at this.
"And besides, if I get bored, there's a medical library right there," Bailey smiled softly.
"Everyone ready?" Kurt asked.
A chorus of yeahs came from the group of teens.
With that, they were off to the hospital.
When the group arrived, Woody, Maya, Bailey, and London went to the posts they had taken the previous day.
As Cody and Kurt walked toward Zack's room, they saw that Carey and a doctor were waiting for them outside the room.
As they approached, the doctor spoke.
"I'd like to go to a room down the hall and discuss some things, if you don't mind."
Cody was confused. "Did something happen?" he questioned, frightened for his brother.
"No, honey," Carey replied. "Don't you remember? They said a doctor was going to want to speak to us."
Cody vaguely remembered a nurse saying the day before that a doctor would need to speak with the whole family as soon as possible. He followed the doctor and his parents to a room down the hall.
The family entered the room. Inside was a single circular table with a few chairs situated around it. On one wall was an x-ray backlight. On another was a whiteboard, and in the ceiling, there hung a projector that was pointed at the whiteboard, though there was no computer connected to it. In the far corner was a small couch.
The doctor, whose nametag read "Dr. Henderson," shut the door and began to speak.
"Feel free to sit down," he said. The three took seats at the table.
"I know that a nurse has filled you in on the basics of Zack's injuries, but I wanted to give you more in-depth information."
"He fractured his left leg in 6 places, three in the femur, one in the tibia, and two in the fibula," he said, putting up x-rays as he spoke about each bone. "The fractures were closed fractures, which means they didn't break skin, but the tibia fracture and one of the fractures to the femur were complete fractures, which means the bone completely separated where those fractures are located. It's actually quite surprising that his femur broke so severely."
"The fractures in the femur required surgery in which we placed a rod in his leg and secured it to the femur with nails. This surgery was necessary because there were three fractures, half of which were complete, and it should help him get back on his feet faster. However, it does come with complications. Many patients who go through this surgery have chronic knee pain afterward. A minority develop muscle atrophy or arthritis. We won't know if Zack will have any of these until he wakes up and the bone heals a bit more."
"Continuing on to his left arm, he broke his humerus in one place, near the elbow. He also broke his radial head, and he broke the shaft of his ulna, which resulted in a Monteggia fracture in which his radial head was also dislocated. The end of his left middle finger was broken in several pieces, and he has a single fracture in his left index finger. Both of the finger fractures should heal quite nicely."
"On his right arm, he seems to have braced himself with it when his car was hit." This elicited a gasp from Carey. The doctor continued. "He has a small break to one wrist bone, but nothing extremely serious on that arm."
"The right wrist fracture should take 3 or 4 weeks to heal. The left arm cast should come off in four weeks, six weeks at the most. His leg cast will definitely be on for six weeks. He also has two rib fractures that should be healed by the time his wrist cast comes off."
When Dr. Henderson finished his sentence, another doctor, this one female, entered the room. She had unruly brown hair and a kind face, and she was wearing khaki pants and a lime green polo shirt underneath her white coat.
"Ah, good morning, Dr. George! You got here right on time," Dr. Henderson said. He turned to explain to the Martins.
"Dr. George is my colleague. I'm an orthopedist; she's a neurologist. She's here to explain his head injury. Trust me, she can do it far better than I ever could," he smiled. Unexpectedly, his pager began to beep loudly, filling the small room with shrill electronic shrieks.
"Ooh, I really need to take this. Dr. George can take it from here," he hurriedly explained with a nervous look on his face as he quickly left the room.
"Hello," Dr. George smiled modestly. "I can imagine how you're feeling right now. I don't know if what I say will help or hurt those feelings."
The three Martins looked attentively at her.
"When your son… and brother," she said, looking toward Cody, "came in, he wasn't breathing on his own. Part of this was due to having a collapsed lung, but we could also attribute it to his brain injury. He didn't severely injure the part of his brain that controls breathing, so he will likely be able to breathe on his own later on. Even when he starts to breathe on his own, we might leave the tube in to maintain a patent airway, since sometimes when someone is in a deep coma, the muscles in the throat can lose their tone, allowing the throat to close up."
"We did an fMRI, or functional magnetic resonance imaging, on his brain, and most of the injuries are to the temporal and parietal lobes, particularly on the left side. This could result in many different complications, but the ones I think are most likely to happen are hemiparesis of the right side of his body or problems with receptive and expressive language processing. We call this type of problem aphasia, and it can affect Wernicke's area, which controls receptive language processing, Broca's area, which controls expressive language processing, or both. Damage to these areas can cause a number of different types of aphasia. If you want, I can get some pamphlets or handouts to you that explain some of the different types." The doctor ceased explaining Zack's injuries for a moment.
"That would be nice," Carey replied quietly, staring sadly into space.
"Okay. I will get those for you as soon as possible," she said with a small smile before diving into her explanation again. "Other parts of his brain were injured as well, including his frontal and occipital lobes. There was a coup contrecoup injury to his brain, which means something made his head stop moving, and his brain bounced off one side of the skull and hit the other. The injuries are more severe on the left side of the brain, probably because that's where the source of his head's deceleration was. Because of that, any problems are likely to affect the right side of his body more than the left. The temporal and parietal lobes were hit more directly, which is why they're more likely to cause problems."
"I also need to explain Zack's Glasgow Coma Score to you. The GCS is a scale that evaluates verbal, motor, and eye responses after a head injury. There are four points for the eyes, five points for verbal responses, and six points for motor response. Zack's current score is a 4, or more specifically, a 4t. That's actually an improvement over yesterday, so I'm optimistic about his recovery. His eye score is a one, which means he won't open his eyes for any reason. His motor score, which we could really only fully test on his right leg, is a 2, which means that instead of a normal response to mild pain inflicted on him, he extends his limb, or stretches it out, instead of flexing it toward himself and away from the source of the pain. When he came in, he wouldn't move at all, so he's already doing a bit better there. His verbal score is a 1, which means that he makes no sounds, but we can't test that response because he's intubated, so he receives a score of 1t, "t" for "tube," in that category. We add all those up to get the overall score of 4t."
The doctor seemed to be almost finished, but still, she sallied forth a small bit longer. "I know this is a lot to take in, and I wasn't exactly very consoling or emotional, but I want you to know that I do care, and I look forward to hopefully seeing Zack make a terrific recovery." The family perked up slightly upon hearing that.
"Are you sure you don't have any questions? You've been awful quiet."
"No," Kurt said as Carey shook her head. Cody just stared at the wall behind the doctor and chewed on one of his fingernails.
"If you need anything or want to know anything about Zack's head injuries or prognosis, you can come to me with any concerns you have. I'll also be in his room a lot, so you can express your concerns when I'm in there," she finished.
"We will," Kurt and Carey replied. Cody was silently taking in everything the doctor had said.
"Well, you can go and be with Zack now if you want," she suggested. She and the group stood up and exited the room, Dr. George heading in one direction and the Martins in the other.
Suddenly, everyone had a whole lot of questions.
A/N: I didn't intend for this chapter to be entirely medical jargon (not to mention really, REALLY boring if you're not into that kind of thing). But the medical explanations got so long that I didn't want to put things from the next chapter into this one, so here's what you get. This chapter could be described as filler, but it's immensely important filler in terms of knowing what's going on with Zack. :P Feel free to review! :) Tell me questions you think they might ask or questions you have, and I might incorporate them into the story! And if you have any qualms with my medical descriptions or errors you'd like to point out, review with that, too!
Next chapter: The Letter Redux