Ryan moaned as he slowly began to wake up again. His head was pounding and his whole body seemed to be throbbing. It took him a few minutes trying to remember where he was. He thought he remembered Kirsten and Sandy saying something about some kind of accident. So that would mean either he was home in bed or… in a hospital? Ryan opened his eyes to look around but quickly closed them. Yeah, it was a hospital room. A brightly lit hospital room. An irritatingly brightly lit hospital room. He moaned a little louder as he rubbed his eyes and was slightly surprised to hear, "Shh. It's okay." This time Ryan opened one eye to find Kirsten standing over him. He closed it again but smiled. "Hey."
Kirsten brushed back his hair, careful not to hit the bandage. "Good morning. You're up early."
Ryan tried to get the sentence out, but could only manage, "Time?"
"It's a little after 8. How are you doing?"
"Fine."
"Really?"
"Mmm. Head hurts. Sandy home?"
"No. He went to get some coffee and to call Seth."
Ryan frowned. Something about Seth was bothering him, but he couldn't remember what. "Seth 'kay?"
"Seth's fine. I promise. I'm sure he'll be here later after school."
"School." He couldn't help but groan.
"Don't worry about school. We've already talked to Dr. Kim, and it's all taken care of." Kirsten picked up a cup. "The nurse brought some water. Would you like some?"
Ryan could only nod in response. He held out his hand and was surprised to feel the straw when it touched his mouth. Kirsten allowed him only small sips like the nurse explained before pulling the straw away. Ryan tried opening his eyes again, but the brightness of the room still irritated him, causing him to moan even louder as he laid his head back on the pillow.
"That bad?"
"Yeah."
"We'll see what the doctor says when he gets here. He said headaches and sensitivity to light are common side effects."
"Great. Else?"
"The doctor will go over it later, I promise."
"Kirsten? Happened?"
Kirsten picked the cup back up and put the straw in Ryan's mouth before hesitantly starting, "There was an accident…" Ryan remembered that being the same thing she said earlier so he cut her off. "Accident. Home. Fell. Not cliff. What do?"
"You didn't do anything. It was an accident."
"In trouble?"
"Of course not." Kirsten patted Ryan's arm lightly. "We'll talk about it later, when you're feeling better. I promise, we'll all sit down and talk about it when you get home."
Ryan once again opened one eye and looked at Kirsten. A sit down to talk about it? Yeah, Ryan thought, that was never a good thing. It began to bother Ryan even more that he could not remember what he did wrong. But Kirsten just smiled at him again as she held the straw up to his mouth.
Neither one of them said anything for a while after that. Kirsten assumed Ryan had dozed off again, and Ryan continued to rack his brain trying to remember something, anything. He was glad to hear Sandy's voice. "One large coffee for my lovely wife!"
"Mmm. Coffee." Ryan smiled slightly. Coffee sounded good. It sure smelled good.
"Hey! Look who's awake!" Sandy in his excitement all but shouted the words, causing Ryan to grimace. "Sandy."
"Oh, sorry. Head hurt?"
"Yeah."
Kirsten quickly added, "And light sensitive." She thought about saying something about Ryan's speech, but didn't want to embarrass him. Sandy only patted Ryan's arm the same way Kirsten had. "That's common."
"So heard."
Another pat on the arm. "Don't worry. Everything will be fine."
"You guys home."
"Maybe later. After we see the doctor."
"No. S'kay. Not lookin', um…"
"We're not looking so what?" Ryan knew without even opening his eyes the look he was getting from Kirsten.
"Look tired."
His words caused Kirsten to laugh. "Nice save. We can discuss it again later after we talk to the doctor. Right now it would probably be a good idea if you tried to get some rest. You're not looking all that great yourself."
"Funny. Sandy? Happened?"
"Ryan!" Ryan opened one eye to find Kirsten standing over him, hands on her hips. "I think you should really try to get some sleep now."
Ryan knew that tone and that look. "Sorry." He closed his eye and his mouth and decided not to argue. He would either have to remember what happened himself or ask the doctor later. Someone had to eventually tell him what he did wrong and why he couldn't remember it.
Sandy waited until Ryan's breathing had evened out and his body relaxed before motioning for Kirsten to follow him out of the room. He looked over at Ryan one last time before Sandy allowed the door to close behind them.
"What was that all about? First you can't wait for him to wake up. Now you're rushing him back to sleep. Mind explaining?"
"He keeps asking about the accident, and I didn't know what to tell him."
"We have to tell him the truth, or rather, Seth has to tell him."
"But Seth isn't here, and Ryan's only been awake for maybe four hours. Now isn't the right time."
"We will have to tell him eventually."
"Eventually, but not before talking to the doctor."
"Talk to the doctor about what?" Kirsten and Sandy turned to find Dr. Richards and another doctor approaching. "Mr. and Mrs. Cohen, you remember Dr. Armstrong, Ryan's neurologist?"
Kirsten and Sandy both smiled and nodded. Kirsten sort of remembered this Dr. Armstrong as one of the people she saw with Ryan, but given the blur of the past few days, she was surprised she could remember her own name. If he noticed her confusion, Dr. Armstrong didn't say anything about it. "So I hear Ryan's awake. We're going to check on him now if you'd care to join us."
Sandy stopped them before they could enter the room. "He's asleep right now."
Both doctors looked at each other and then at Sandy as Dr. Armstrong frowned. "He hasn't woken up at all this morning?"
"No, he has…" Kirsten started, but Sandy continued, "but Kirsten told him to go back to sleep."
Kirsten started to talk quickly, before either doctor could ask, and she knew they were going to ask by the look on their faces. "It's just… he keeps asking about the accident. How it happened, and we don't know what to tell him. I thought maybe we should discuss it with you first, see what you thought and then talk to Ryan about it."
Dr. Armstrong scanned Ryan's chart. "It says here that Ryan fell off a ladder. I don't understand – what's there to discuss?"
Again Kirsten began to talk fast. "Seth was supposed to be holding the ladder that Ryan was on, but he walked away for a minute. Somehow while Seth was gone, the ladder fell and so did Ryan. Since he doesn't remember the accident, we don't know if he realized Seth had walked away, so we don't know how mad he's going to be, and well, we're not sure what to tell him about it."
Dr. Armstrong looked at Dr. Richards. "Seth?"
Dr. Richards just shrugged. "The other son."
Both doctors then looked at Kirsten, waiting for more. Kirsten twisted her wedding rings around her finger, trying to figure out how to make them understand without going into the entire family history. "Look, we already had a really long summer. Neither boy was living at home. They weren't talking to each other, and they were barely talking to us. Ryan only talked when we called him. Seth wouldn't even do that much. I just… I don't want us to go back to that again."
"Mrs. Cohen," Dr. Armstrong started. "I understand your concern, but as you know, Ryan will eventually remember the accident. Maybe not today or even tomorrow, but he will remember it. If he asks, it would be better to be honest with him, and I would guess that he's going to be upset with Seth, but I'm sure they'll work it out. Brothers usually do. When I was a kid, my mother would always tell my brother and me to kill each other quietly, which we did, and in the end, we always worked it out."
Kirsten knew that this Dr. Armstrong was just trying to be nice, trying to appease her, but it didn't help. Since there was no way she was going to go into the whole foster son/trust issue thing with this guy, she just smiled, nodded and walked into Ryan's room.
"It might be better if we woke him," she whispered. "That way he won't be confused or upset."
They were all surprised to hear, "Not sleep."
"Hey. I thought you were going to get some sleep." Kirsten spoke softly so Ryan wouldn't think she was mad.
"Sorry. Rest. Not sleep."
"Don't be sorry," Sandy said. "There are a couple of doctors here who'd like to see you so it kind of helps that you were only resting."
Ryan nodded, but didn't open his eyes as Dr. Richards approached the bed first. "Hi, Ryan. I'm Dr. Richards. I just need to take a look at your stomach and chest, if you don't mind."
Again Ryan nodded without opening his eyes. He knew he really didn't have much say in the matter. Plus at least this way, maybe someone would finally tell him what the hell happened. Ryan felt his covers being pulled down and grabbed at them quickly since it seemed like the doctor was pulling them down just a little too low. He knew all he had on was a hospital gown and once the covers came down, the hospital gown would go up, and well, he wasn't sure what kind of show this guy was about to give Kirsten. Dr. Richards tried to tug the blankets free from Ryan's grasp. "Ryan, I need to examine your abdomen."
"That not abdomen," Ryan struggled to say, his hand still firmly grasping the covers. He heard the doctor laugh when he realized what Ryan was getting at. "Sorry. Didn't mean to get too personal, but I do need to check." Ryan held tight to the blankets, making sure they stayed by his hips as he felt the hospital gown going up.
All thoughts of the blankets quickly went out of his head when the doctor started to poke and push on Ryan's stomach. It hurt a lot, and Ryan could only grunt and hiss as the doctor moved his hands over Ryan's stomach, pushing here, poking there. "Sorry. Real painful?" Ryan managed to hiss "yeah" through gritted teeth as the doctor pushed again on his stomach.
"I can give you something for the pain when we're done. Okay?"
"Kay." Ryan grunted again as the doctor continued. It was a relief when Ryan felt the doctor remove his hands from his stomach and place a stethoscope on his chest. That is until the doctor said, "I need you to take a deep breath."
Ryan's deep breath was short and more like a gasp as the pain shot through his body. He was not very happy to hear the doctor say "again."
It helped calm him a little bit when Ryan felt a gentle hand on his leg and a firmer squeeze on his ankle. He didn't need to open his eyes to know Kirsten and Sandy were still standing there. It wasn't easy, but Ryan took as deep a breath as possible and tried not to groan as the pain again shot through his body. It was a bigger relief to feel the doctor remove the stethoscope and then pull down the hospital gown.
The doctor then grabbed his left hand. "Squeeze my hand, Ryan." Ryan squeezed as hard as he could, since it didn't really hurt, and well, truth be told; he kind of wanted to hurt the doctor just a little for hurting him first. Unfortunately all the doctor said was, "very good" as he pulled his hand free of Ryan's.
"Mr. Cohen, can you uncover Ryan's left foot?" Ryan opened one eye just a little and watched as Sandy pulled up the covers, exposing a big white cast and his toes. Ryan watched as the doctor moved down to the end of the bed. "I need you to wiggle your toes for me, Ryan." Even though Ryan thought it was a stupid request, he complied anyway.
"Okay, very good." The doctor covered Ryan's leg back up. "So far, so good. Everything seems to be healing nicely from my perspective. Ryan, that's all from me, for now."
"Thank God," Ryan muttered, shifting in the bed and thinking just maybe Kirsten was right when she told him to go to sleep.
"Sorry, pal, but now it's my turn." Ryan opened one eye to see the other guy in the white coat approach the bed. "I'm going to need you to open both eyes, as wide as you can."
Ryan closed his eye again and shook his head. "No. Hurts."
"What hurts?"
"Lights. Too bright. Hurts eyes."
"Okay, so let's start this way. What else is bothering you besides the lights?"
"Head hurts."
"What else?"
"Talk stupid."
"Ryan, you don't talk stupid." Ryan sighed. He knew Kirsten would make a comment, the second he struggled to get out the words; he just knew Kirsten would say something.
"Anything else?"
"Don't 'member."
"Don't remember what?"
"Accident."
"But you can remember everything else? Your family? Where you live? If I asked you where you were born, what would you say?"
Ryan frowned. "Hospital."
"Which hospital? Where?"
Ryan again frowned, and then shifted in the bed before turning his head away. "Fresno."
Dr. Armstrong looked at Kirsten and Sandy, confused by the sudden change in Ryan's demeanor. Kirsten took a step closer to the bed. "And if I asked what happened to the Range Rover last summer?"
"Imax. Shark Movie. Very violent."
"Uh huh. And your little side trip to Tijuana?"
"No. Comi-con." Ryan just smirked as he relaxed again.
Dr. Armstrong wasn't exactly sure what was going on, but as far as he was concerned, at least Ryan's memory wasn't impaired. "Okay, so it appears the only thing you don't remember is the accident. You will shortly. If not, then someone will explain it. So, moving on. As for talking stupid – your speech will gradually improve. In the short time we've been in the room, your speech has already gotten better. The more you talk, the faster it will improve."
Ryan opened one eye to find Sandy smirking at him. "Don't say."
Both Sandy and Kirsten couldn't resist laughing. "Say what? That you now have an expert medical opinion stating that you must talk more? Maybe Dr. Armstrong can put it in writing for us. You know, as a reminder. Big bold letters - Ryan Must Talk More."
Again, Dr. Armstrong was confused by whatever inside joke this was, so he just continued on. "As for the headache, that's to be expected. That could last for several days, weeks, even months. But there are medications that will lesson the severity, and over time the pain will diminish until one day you notice the headache is completely gone. Same with the sensitivity to light. Have someone bring you a pair of sunglasses. That will help. Also, we'll be moving you to a step down unit in a little while. Not so bright. You'll be able to keep the lights off and the shades drawn. You also won't be attached to so many machines, less noise. All those things will help. How about dizziness or nausea?"
Kirsten started to shake her head no. Ryan hadn't complained about them, so she was a little shocked to hear Ryan say, "Yeah. Both. Little."
"Again, common. And again, they'll both get better over time. After you're moved to your new room, we'll start you out on a liquid diet. Hopefully some of the nausea will go away from eating. But be prepared, you may also vomit."
"Great. Can't wait."
"Okay, pal. That just leaves one last thing. I need you to open your eyes as wide as possible. Sorry, but I do have to check your pupils, and I can only do that with your eyes open."
Ryan groaned but turned his head towards the doctor. Dr. Armstrong took his penlight and held it up to Ryan's right eye. "Okay, open your eyes." Ryan opened his eyes, not expecting the assault with the flashlight. He quickly shut them again as he jerked his head away. "Ryan, you need to look at me."
"No."
"Ryan, you need to open your eyes and look at me. Come on, real quick."
"No."
Dr. Armstrong looked at Kirsten and Sandy. He didn't want to have to force the kid's eyes open, but if he had to, well, he would. Sandy patted Ryan's leg. "Ryan. Come on. Open your eyes and look at the doctor."
"No."
"Ryan…" Sandy started, but really wasn't sure what to say. He had no words of wisdom for this particular case.
Kirsten walked over to the side of Ryan's bed and slipped her hand into his. She bent down close and whispered something into his ear. Ryan made a face, then sighed as he turned his head towards the doctor.
"Okay. Ready. Open your eyes." Ryan did as the doctor ordered and was quickly assaulted with the flashlight again. He groaned as the doctor then moved the light over to his left eye. "Very good. Okay, you can close them now."
He didn't have to tell Ryan twice as he closed his eyes tight and turned his head away from the guy. Kirsten smiled and gave him a kiss on the cheek. "Thank you."
"Pupils are equal and responsive."
"Yippee," Ryan muttered. He didn't know what that meant, and at that point, he didn't care. He just wanted these people to go away. He was tired, and he wanted them to just leave him alone. Kirsten, too. He should have known she wouldn't play fair. No one could force him to open his eyes, but Kirsten certainly knew how to make him.
Ryan could particular hear her smiling as she and the other 'adults' moved to the side of the room to talk about him as if he wasn't even there, or worse, as if he were a small child.
"Very impressive, honey. Care to fill us in?"
"In on what?" Now Ryan knew Kirsten was smirking, especially when he heard Dr. Armstrong say, "it's a Mom-thing, right Mrs. Cohen?"
"You could say that. Is Ryan really okay?"
Ryan tried not to make it look too obvious that he was listening. "I'd say we're both very happy with Ryan's condition. The fact that he was able to stay awake this whole time is a very good sign. As Dr. Armstrong explained, Ryan will be moving to a step down unit as soon as it can be arranged. I'll leave a standing order for pain medication, every four to six hours as needed. I'd like to see Ryan try to eat something later this afternoon, maybe sit up in bed or even a chair by this evening, and up on his feet with some help by sometime tomorrow. If he can accomplish all that, hopefully we can get him home by the end of the weekend."
"That fast?" Kirsten said. "I mean, no offense, but aren't you moving a little fast? He just woke up a few hours ago."
"Now that he is awake, you'll be surprised at how fast he'll progress. He will still need plenty of bed rest as well as a great deal of care once he is home. You may even want to consider home health care. Until then, though, we'll be disconnecting the heart monitor once he's moved. The catheter can come out tomorrow, but the IV has to stay in. We need to continue the IV antibiotic therapy for a full seven days. He'll remain on oral antibiotics after he's discharged. With the loss of Ryan's spleen, you'll want to do what you can to reduce his exposure to illness so keep visitors to a minimum. Only immediate family. I would also recommend that for the holiday season as well."
Dr. Richards waited for the Cohens to nod that they were following him up till that point before continuing. "Bring whatever he'd like from home. Slippers, bathrobe, pajamas, sunglasses, whatever will make him most comfortable. Hold off on any reading material or hand held computer games. Those as well as television will be a little too difficult for now. The same goes for music. Don't bring an iPod or anything like that. Any questions?"
Ryan waited for Kirsten or Sandy to say something. He sure as hell had some questions, so he knew they had to as well. He was shocked to hear Kirsten say, "No. I think we got it all," and Sandy say, "Thank you." He waited for the goodbyes and for Sandy and Kirsten to come back over by his bed before asking the questions that had immediately come to mind.
"My spleen?"
Kirsten gave an "um…" before Sandy explained. "Yeah, kid. They had to remove your spleen. It was ruptured. I know it sounds really bad, but they tell us people live pretty normal lives without one. There are some precautions we'll have to take, but over time your body will adjust and organs like your liver will compensate for the loss."
"Precautions?"
"Yearly flu shots, short term antibiotic therapy, nothing too traumatic, I promise. Okay?"
Ryan laid his hand on his stomach. "Um, kay" was all he could think to say. He was quiet as he slowly moved his hand back and forth, rubbing where he could feel the incision was. He felt Kirsten lay her hand on top of his and give it a gentle squeeze. He never heard the nurse come in nor did he know she had once again injected something into his IV. She left just as quietly as she came in, only smiling at the Cohens as she left.
After a few minutes, Ryan asked, "Day is it?"
"It's Wednesday."
"Hanukkah?"
"Don't worry about Hanukkah. It doesn't matter."
Ryan knew it didn't matter to Kirsten, but it did to Sandy and Seth. "No, go. Celebrate. I'm 'kay."
"Hey, come on," Sandy said. "We can't celebrate without you. Hanukkah can wait until you're feeling better. After all, it doesn't matter when we celebrate as long as we celebrate together."
Ryan was now really getting very tired but wasn't ready to end the conversation. "Mmm. Celebrate here?"
As he began to drift off to sleep, he heard Sandy say, "I think that's a good idea, but only if you're up to it later. You know – the start of Hanukkah is the kick off to the whole Chrismukkah season."Ryan frowned as he fell asleep. That sounded so familiar…
