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Part 18

It was a further forty minutes before Kim's doctors came back, having gone over her scan results.

"I wish I could tell you more than I already have, Commander, Major, but Kim's scans show little difference from the first set we took today. There is still some slight bleeding going on in several places inside Kim's brain, but the fact that it hasn't gotten much worse is a definite positive sign. Much of the swelling comes from the areas around the skull fracture and where the contusions have occurred..."

"Are these areas of damage likely to cause Kim any significant…im-impairment, once she comes home?" Harm could not help but feel rather overwhelmed by the terminology used.

Here, the second doctor took over, since he had much more experience in the field of traumatic brain injury.

"At this point, while Kim is still comatose and unconscious, it is very hard to say. We know what functions these affected areas of the brain control, but the extent of any damage very much depends on the impact sustained and will vary, from person to person. The bleeding now seems to be minimal, so we are hopeful that it won't get any worse, but we can only observe Kim's functioning when she wakes up, in order to best assess the damage. Anything else would only be conjecture."

"How large are the areas that have received damage? Did Kim sustain many blows to the head?" Harm asked

"Two areas of bleeding are much larger and more serious, but the third is much, much slighter, much less serious. Based on these injuries, we think there were only two blows to Kim's head"

"But how? I thought Kim had bleeding in three areas…" Mac shook her head.

"Multiple areas of damage, such as the ones that Kim has, are caused by the brain impacting against the inside of the skull. That is why there's usually more than one, since the brain does not remain static, but often bounces back and forth a few times. This is called 'contracoup.' As far as the extent of these areas of bleeding, they are serious, but I've often seen worse, in my career. In a few hours, we'll take some more scans, so that we can ascertain if the bleeding has completely stopped, in all areas. If it has, we'll make a decision about whether to operate, to remove the blood clots."

"And the skull fracture?" Mac asked, "How serious is that?"

"It is a large fracture," Grant admitted, "but it isn't depressed, so there is no injury to any of the protective linings that surround the brain. That reduces the chances of infection, substantially. We are more concerned with the blood clots and the swelling, at this time. All her other injuries will heal with time, but we have to focus on doing whatever we can to treat the damage and minimize the swelling."

Harm and Mac nodded in understanding.

"Do you have any idea when she might wake up, Colonel?"

"I'm afraid that is up to Kim…"

Once they were alone again, Harm and Mac settled back into one another's embrace.

"I can't believe this is all happening…I really should go call my parents, but I'm afraid to leave her…"

"I'll stay with her, if you're ready…If not, let's give it another hour then you can consider it again…"

"It's not like an hour more will make a difference," Harm shook his head, "I'm still probably going to be as much of a mess then as I am now…I think I should just go make the call. It's only going to get harder to tell them what I have to."

He stood up from his seat and Mac squeezed his hand, encouragingly.

"Okay, we'll be right here. Don't worry; I'll take good care of Kim."

Harm gave her a grateful smile, forcing himself out the door and to the nurse's station.

"Could you tell me where the nearest payphone is, please?"

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Despite their protests, Harm convinced his Mother and Stepfather to remain in the States. It was a long journey to get from La Jolla to Bali and there was little they could do, if they were to travel all that way.

Over the next day, Kim's condition remained the same. There was no improvement, but conversely, there was no decline. The scans indicated that bleeding had indeed stopped in all three areas of injury, but Colonels Grant and Redgrave wanted to hold off on more serious surgery for now. They did, however take Kim down to the OR, in order to insert a plate into her broken collarbone and some pins into the fractured bones of her right arm. Her fractured right arm had been set and plastered without much trouble, before she was moved down to the OR.

When Colonels Grant and Redgrave came around to examine Kim again, that evening, Redgrave explained the whole procedure, while Grant performed the neurological exam.

"Doctor Grant is performing the neurological exam, called the Glasgow Coma Scale, to assess Kim's state of consciousness. When she was first admitted, we did the same series of tests and came to the conclusion that she was not just unconscious, but comatose. She was unresponsive and unaware of anything going on around her. She did not exhibit normal sleep-wake cycles, she could not be roused by stimuli that were uncomfortable or even painful. I know this may not make any sense to you, but it is a necessary and useful way for us to assess her condition and by recording all this, it will help us better provide rehabilitation, once she wakes up. And by scoring Kim on each of the different sections of this exam, we are able to see how her condition improves…"

"It seems like Kim's condition has improved, slightly," Grant interrupted, "But she is still deeply comatose…She is still scoring well below 8 on the Glasgow Coma Scale, but this is normal for an individual who is comatose, especially one like Kim, whose eyes are unable to open and who is unable to speak anyway, due to massive facial swelling. This scale is also very useful once patients have emerged from coma, because it helps us assess their present state, track their improvement and assess their injuries, once they condition has stabilized."

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