September 18, 1944, Akron Children's Hospital
"I've got rather a surprise for you Kurt,'' Kurt raised his eyebrows rather skeptically as Nurse Gold finished brushing his teeth. It was mid morning, and Kurt had already had his breakfast and his first therapy appointment and was bored enough to be interested in whatever surprise his nurse was referring to.
"This afternoon they're going to bring in a bed for you, to see how long you can breath by yourself, and to try and have you sit up a little, it will be good for your back, and will make your therapy easier. You'll be able to get more practice breathing on your own. And we'll have more room to stretch you out- alright, rinse.`` She gave him a sip of water and allowed him to rinse his mouth.
"That sounds nice, I suppose." In truth he wasn't entirely sure of the point of it, but it did in fact, sound nice. The mattress in the iron lung was narrow and not particularly comfortable, and being turned in the small tube was rather difficult. It seemed like an awful lot of extra work for the nurses to move him from bed to respirator and back multiple times a day, but he couldn't say he minded the idea. After all he wasn't the one with extra work because of it. He'd be able to see the room more too. Maybe the bed could even be pushed up to the window so he could see outside. Outside seemed like a magical, almost a fantasy world beyond his reach. Like Alice's Wonderland. And just as impossible too, just as out of reach. The places that had once been so familiar, the shops on Main street, the library, his father's garage, even his own home, seemed worlds away. He tried to imagine being moved back into his childhood bedroom in an iron lung, or imagine his father pushing him down the street in a wheelchair. The two realities didn't fit somehow, like mismatched pieces of a puzzle. It almost felt as though nothing outside this tiny hospital room existed for him anymore. Like the outside world was a kind of dream, and he was trapped in the nightmare version of that dream. He longed for even a few minutes of sunlight, just to be able to look out the window. It stood no more than five feet away from his iron lung, yet it might as well have been miles away.
He had always gone outside to feel most himself. He would walk down the road until the houses turned to trees. As a young child these woods had been his playground, after his mother died, it was where he went to cry so no one would know. They were where he had first started running in the aftermath of his rheumatic fever, and it was where he and Blaine had first started to explore each other, shirts coming off, kisses running down each other's bodies. Trousers coming off and hands exploring places they weren't supposed to.
He missed smelling the air, he missed the sun, there would be precious few weeks of sun left, and he hated to miss them. He wondered if the leaves were already beginning to turn, it was a bit early perhaps, but some surely would be.
"Do you think I might be able to sit up enough to see out the window?" he asked, the hope evident in his voice.
"Maybe. More likely after a few times trying it out though. It might seem an easy enough thing since you'll be propped up, but you've been flat on your back for over a month. Your body won't be able to tolerate sitting up very high, or for very long, not at first." Kurt furrowed his brows. He'd never thought that he would have any trouble just being propped up in bed. The only problem he had anticipated was his lack of use of the muscles in his neck and back.
"Why's that?"
"You'll probably feel dizzy, maybe even sick to your stomach. Do you know anything about blood pressure?"
"Not really. I remember Dr. Warren brought a machine to measure it a few times when I had rheumatic fever. It looked a bit like something out of 20,000 Leagues Under the Sea"
"Well, normally your blood pressure changes a little bit when you sit or stand from lying down. Since you've been lying down for so long your blood pressure doesn't fluctuate much at all, and your body will have gotten used to that. When you sit up for the first few times it will probably drop a great deal as soon as you sit up. When your blood pressure drops you'll get dizzy, you might feel funny. Some people faint, or vomit even. We'll only raise the head of your bed a very little bit the first time we try to sit you up."
"Will that always happen?" Kurt asked, his stomach clenching and his lip curling involuntarily.
"No, no, once you're able to start sitting up more often, and for longer, your body will get used to it again. Once you're able to do it daily you won't have any problems at all." well at least there's that, Kurt thought cynically.
"Why didn't that happen when I had rheumatic fever?" He wondered aloud. He remembered being dizzy when he had sat up in bed or gotten up to go to the bathroom, but he had thought that had been because of the headache and fever.
"You were probably still able to move around enough to prevent it. Besides, rheumatic fever can cause dizziness itself so you may not have noticed." she must have seen how worried he looked because she gave him a reassuring smile,
"It's really nothing to worry about, we just like for patients to know so they aren't frightened or think that anything is wrong. Now, let's finish getting you cleaned up." She took a washcloth and began to wash his face, before opening the iron lung and beginning his morning sponge bath.
A normal hospital bed was wheeled into his room just after lunch, and Kurt lay there, staring at it for quite some time when Dr. Carmichael, his step mother, Miss Phillips, the respiratory therapist, and Nurse Gold.
"Hey Kurt, how are you doing? Ready to try this." Dr. Carmichael asked, his voice gentle and calming.
"Yeah. I'm ready."
"Good. We'll start just letting you lie on the bed for a couple minutes, get your breathing settled, then we'll slowly start to raise the head of the bed so you can get used to it, alright? Hopefully sitting up will ease your breathing a little bit. What is most important for us right now is to get you out of the iron lung as much as possible. Have your nurses talked to you about muscle atrophy?"
"Yeah, that's why they do the physio right?" Dr. Carmichael nodded, smiling his, in Kurt's opinion, rather handsome smile.
"Well, just like the muscles in your arms and legs atrophy, the ones that work your lungs- the intercostal muscles, those are the muscles around your ribs, the diaphragm, even your neck and abdominal muscles- can all atrophy. Some of that atrophy is unavoidable, a consequence of paralysis, but some of it is caused by muscles that could be starting to wake up not getting any exercise because the respirator is doing all their work for them. And we have to get those muscles working again." Kurt cut him off,
"Can it be by the window? The bed- can you make it so I can see out the window?" He knew he should care about what the doctor was saying, and would later, he would do anything he could to breathe on his own again, but he just wanted to see the sun again. Dr. Carmichael smiled again, laughing lightly.
"Of course, we'll get an orderly to move it up to the window. Nurse Gold, would you mind?" he asked, turning to the Nurse,
"Of course Doctor." she answered, excusing herself.
It was far less uncomfortable to be moved to the bed than it had been to be moved from isolation. The orderlies were efficient and his muscles were somewhat less achy than they had been fresh from the illness. The real mattress felt like the most luxurious featherbed, even if Kurt knew it was only a stiff hospital mattress, but compared to the mattress pad in the iron lung it was heavenly. He breathed in as deeply as he could, smelling the crisp, fresh sheets. Dr. Carmichael patted his shoulder, smiling kindly,
"You're doing really well Kurt, you're breathing really well. I can tell your chest muscles and diaphragm are getting stronger. I'm just gonna take your blood pressure and pulse before we start trying to sit you up. Did Nurse Gold explain that you might feel dizzy?" Kurt tried to nod but his neck was still very weak.
"Yes, she talked to me about it this morning."
"Could there be problems because of his heart murmur?" Carole asked, taking Kurt's hand and squeezing it.
"No, no, he should be fine, but I'll listen to his heart to make sure. He developed it after a bout of rheumatic fever, correct?" Carole nodded,
"Has he been screened for rheumatic heart disease?" Dr. Carmichel asked, flipping through Kurt's notes.
"Yes, when he turned eighteen he tried to join the army, and that's when they discovered the murmur. It hadn't been present before that so Dr. Warren had him examined. They said it was most likely due to the rheumatic fever but that there wasn't any indication of further heart disease. His heart's always been strong and we kept him on bedrest to help protect his heart during the fever." Dr. Carmichel smiled,
"Then there's no reason to think there should be any problems, a heart murmur really isn't dangerous most of the time. Something like rheumatic fever being the cause makes us a bit more concerned, but even then it's usually quite benign so long as the patient has never had any symptoms related to heart problems. Which as far as I can tell Kurt hasn't. Even if he does faint, I promise it's perfectly normal." Kurt winced, he really, really, didn't want to faint.
"Alright, then, let's get you sitting up. Kurt gritted his teeth and nodded.
"I'm ready," he said, with rather more confidence than he felt. Dr. Carmichael went to the foot of the bed and began to turn a large crank, slowly the bed began to raise, and soon Kurt could just see over the windowsill to the leaves of a large maple tree outside.
"The leaves have changed," he murmured in wonder, Carole squeezed his hand, leaning over him to push his fringe out of his eyes and kiss his forehead.
"Yes darling, fall's come a bit early this year." He smiled up at her, the branches and leaves beginning to glitter as tears stung the corners of his eyes. The bed stopped at about a forty five degree angle and Dr. Carmichael returned to his side, patting his shoulder in a fatherly manner.
"You're doing really well Kurt, let me just check your pulse and give a quick listen to your heart and lungs before we continue. Are you feeling nice and comfortable?" In truth Kurt's heart had begun to pound rather dramatically, and his back and hips hurt as the muscles were put into a new position after so long, but at the same time it was lovely to change position, even if it meant struggling to breathe outside the iron lung.
"I'm alright. It's wonderful to see more." he couldn't take his eyes away from the window, full of trees and sky.
"No pain?"
"Nothing terrible, my hips a little I suppose, but it feels lovely..." he had to stop for a moment catching his breath. The weight was beginning to return to his chest, making it difficult to string more than a word or two together at a time.
Dr. Carmichael returned to the head of the bed and took Kurt's pulse, eyebrows furrowed.
"Your heart rate is a bit elevated, let's leave you where you are for a minute before we sit you up any further. How's your breathing?"
"I'm starting to - feel it, I think." Kurt replied, his breath hitching.
"Just try and breathe easy, use some of the techniques you've learned in therapy." He breathed as deeply as he could, practicing the "frog breathing" he'd learned from Miss Phillips. His breathing eased a bit and he could feel his heart rate evening out.
"I'm ready to try again," he said, more confidently than he felt.
As Dr. Carmichael raised the bed to somewhat under 90 degrees, the dizziness returned, and his heart rate increased again, but he didn't care, he could see the trees and the building across the street, the people going about their daily lives on the street below. That, he thought, made it all worth it. Kurt grinned broadly, looking up at Carole and his doctor with great emotion.
"It's beautiful. Thank you," He twitched his fingers slightly, and Carole squeezed his hand gently.
"You're doing so well darling" Kurt could see tears in her eyes as she leaned over to kiss his forehead. Kurt wasn't sure how long he sat there, staring out the window at the trees and sky, focusing on his breathing, just enjoying getting to see something more than what he could see through the mirror attached to the iron lung.
After some time he could no longer fill his lungs, and his breathing became more and more labored. He focused everything he had on his breathing but Dr. Carmichael had already ordered the nurses to prepare him to move back to the respirator. His vision began to blur as he felt himself being lifted and moved back to the iron lung's cot.
"You've done incredibly well Kurt, you really have." Dr. Carmichael reassured, "your breathing is improving, and you're responding fairly well to changes in position. Minor orthostatic intolerance- your heart was struggling a bit to keep up with the change, but over time you will develop greater tolerance for sitting. With support you're able to maintain balance as well, which tells me some of your neck and torso muscles are starting to come back. It also means we may be able to get you into a wheelchair in a few months." Kurt smiled rather tiredly up at his doctor, and he felt Carole behind him combing his hair gently with her fingers.
"Why don't you get some rest darling, you've done so well," Kurt murmured a soft affirmation of agreement and closed his eyes, relaxing into the rhythm of the iron lung once again. He let the image from outside his window flood his mind, imagining how the crisp, early fall air would smell. How it would feel against his skin. He smiled, letting the strange feeling of pride settle in his chest. He had sat up- not exactly on his own- but he had sat up, for the first time in over a month. He was breathing on his own, better and longer every day. He could move his hands. He never thought he could be pleased by such small things, but he was. He might be miserable and angry much of the time, he might be resentful of his body, of the illness that had taken his health and independence from him, but right now, this minute, he was proud of the lungs that had breathed for that short time, he was grateful for the body that could sit up in bed. It was strange, he thought, as he began to drift off to sleep, how quickly he was becoming used to living in a paralyzed body, how quickly he was becoming grateful for even the smallest of victories. Any victory, he supposed, in his current circumstance, was enough.