Title: The Sound of Silence
Author: FraidyCat
Disclaimer: The disclaimer provided prior to chapter one is all-inclusive, like a really fine vacation.
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Chapter Two: The Walls Are Closing In
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Don had never been claustrophobic, but there was a first time for everything. The exam cubicle was crowded already with equipment. Add his father and himself to the mix, and then draw closed the privacy curtain, and Don's skin began to crawl. He sat silently, focused on his brother's sleeping face, and took no comfort from the laxness he saw there. As he stood to pace around the gurney, though, he told himself it was a good thing that Charlie slept. If Don was bordering on claustrophobic hysteria, the atmosphere would not bode well for Charlie.
He tried to distract himself from the hideous beeping of the monitor by searching his memory. When, exactly, had Charlie developed claustrophobic tendencies? Perhaps it was at Princeton. A thirteen-year-old -- and a small one at that -- surrounded by people so much bigger and older than himself; it must have been overwhelming, especially at first. At least in high school he had known his big brother was nearby; even if, Don winced, he didn't necessarily know if Don would be a positive or negative force on any given day. Don shivered a little and executed an about-face at the head of the gurney, still contemplating. Perhaps something had happened at Oxford, during the Susan Barry years. Don didn't know a whole lot about that relationship. He had been so stunned at the picture of his twenty-something kid brother living with that statuesque, nothing-short-of-gorgeous blonde when she had shown up a few years ago, that he hadn't even asked. He jingled the change in his pocket and decided that all he really knew about Charlie's need for space was that by the time he had transferred from Albuquerque, there was a difference. Charlie always sat on the aisle, or as close to it as he could get. If he joined the team for lunch, he let everyone else slide into the booth first. Don had noticed that he never lingered on the elevator, and sometimes took the stairs. Charlie never made a big deal out of his claustrophobic behaviors, but Don was a trained observer. He knew issues when he saw them.
"Huh," he mumbled, preparing to turn again at the foot of Charlie's gurney.
Alan was suddenly, inexplicably, in his path. He hadn't even noticed that his father had stood from his chair. "What?"
Don blushed, embarrassed although he wasn't sure why, and regarded his feet. "I was just thinking about claustrophobia." Alan arched an eyebrow and waited for Don to continue. His eldest lifted his head and glanced at him and then at Charlie. "Charlie's a little claustrophobic. He was never that way as a kid, and I was just wondering when it happened."
Alan followed his gaze and smiled fondly. "I'm not sure. It's not bad. He flies all the time, uses elevators...but I know what you mean. He likes to be on the edge of the crowd, and close to an escape route at all times." He looked back at Don and shrugged. "I guess I never defined it with that word. He came back from Princeton that way -- kind-of set apart -- I thought it was just part of the curse of genius."
And that simply, Don was angry. "Well, he's screwed either way, now," he said roughly. "His genius may be gone, and with no voice he's trapped inside his own head!"
Alan looked shocked and took half a step back. "Don! Son, don't talk that way!"
Don half-turned toward the small gap in the privacy curtain, a growing panic demanding air, but stopped when someone pushed through from the other side. The casually-dressed middle-aged man nodded at Alan and then extended a hand toward Don. "Dr. Varminni," he greeted cheerfully. "Call me Dave." Don glared at him as if the doctor were personally responsible for his brother's condition and eventually the physician moved past him to the head of Charlie's gurney. "The CT scan clearly indicates a stroke," he commented to the room at large. "Left hemisphere of the cerebrum."
"That must control speech," Alan guessed, remembering with a shudder Charlie's inability to talk.
The doctor nodded. "The left side of the brain is responsible for speech, as well as scientific function. Things like reasoning, say, or...the ability to work with numbers."
Alan made a noise of distress and Don growled. "Son of a bitch."
Dr. Varminni looked at them with interest. "Don't tell me he's an accountant, or something."
Don turned his back on the doctor and Alan stepped a little closer so that he could rest one hand on Don's arm and the other on Charlie's blanket-covered foot. "He's a professor of applied mathematics at CalSci. He began Princeton at the age of 13; he's always had a gift with numbers."
The doctor's face clouded and he shook his head, returning his attention to the gurney. "Charlie!" he called loudly. "Charlie, I need you to wake up, now!" Don figured the command must have worked, because the next thing he heard was the doctor asking his brother if he could feel his father's hand on his foot.
Don squeezed his eyes shut and swallowed against bile when Charlie responded. "Uuuhhh. Uuuhhh. Uuuhhh."
The gutteral grunts didn't seem to phase the doctor any. "Good. That's good. Can you tell me how you're feeling, Charlie?"
"Uuuuuuuuuuuuhhhhhhhhhh." This time the sound was more like a long groan.
Dr. Varminni pressed onward. "All-right, son, let's just try some 'yes' and 'no' questions. Do you have a headache?" Don found that he was straining to hear the answer, and reluctantly he turned back around. Charlie was looking right at him, his mouth opening and closing. No sound was coming out at all, and Charlie's eyes slid away to look up at the doctor. The man smiled, and asked another question. "Do you know who is standing at the foot of your bed?"
Charlie's eyes drifted closed. "Uuuuuhhhh."
The doctor changed tactics again. "All-right, Charlie, I want you to move both legs for me. Do it now!" Don tensed at the doctor's tone, but was relieved to see movement under the blanket -- from both legs. "Fine," the doctor praised. He reached out to lower the blanket a little, revealing a pulse-ox monitor on one of Charlie's fingers. "Now, raise both of your arms." There was no movement for a moment and Don felt renewed panic rising in his chest. "You can do one arm at a time," the physician encouraged, and suddenly Don saw Charlie's left hand, the one with the pulse-ox monitor clipped to a finger, rise briefly and then settle to the bed. In a few more agonizingly slow seconds, he raised his right hand all the way to his forehead, which he touched before that hand too collapsed to its original position.
The doctor's smile grew wider. "Excellent. You're telling me that your head hurts?"
"Uuuhhh," Charlie whispered, blinking sluggishly.
Dr. Varminni raised the blanket again and patted Charlie a few times on the shoulder. "I'll put something for that in the IV," he said, almost conversationally. "Jim is going to come in and start one now, and then we'll move you into some of our fine accommodations upstairs." Charlie didn't respond, and the doctor stepped away from the gurney and motioned to Alan and Don. "If you'll come with me," he offered, "we can discuss some things while Charlie's settled into a room."
Don didn't want to leave his brother alone, but knew that he would be in the way, here. Plus, he was desperate to hear something -- anything -- that might shed the light of hope onto this nightmare. Lastly, if there was nothing hopeful to share, he knew he had to be there for his father when he heard those words.
After a last, long look at Charlie, Don turned and followed the others out of the room.
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Dr. David Varminni concentrated on the father, mostly because the other one -- the one introduced as the brother -- made him just a tad nervous. The three of them sat in a family consultation room, and by design it was located off the beaten path; too far from security personnel to risk pushing the wrong buttons on this dude. The way he hunched at a low simmer in his chair, scowling at his knees, which were bouncing up and down at a frantic pace, was not encouraging.
Still, he had to tell the truth.
"To be frank, Mr. Eppes, I'm not sure how much your son will get back. The acute phase of stroke recovery, when comprehension is most impaired, is considered about 1.8 days. Based on your report that you spoke with him a little after midnight before finding him at 5:30 this morning, and taking into consideration his age, we did decide to administer the tPA."
The doctor had been leery of the younger man before, but now his heart went out to him in sympathy when the brother's head shot up, desperate hope flaring in his eyes. "That will fix him, right? That's the stuff you can give to fix them!"
Dr. Varminni responded gently. "You need to understand -- Don, is it?" He went on at Don's affirmative nod. "While it is true that tPA can prevent serious and long-lasting consequences from a stroke or heart attack, it is also true that it is only effective if administered in the first three hours." He shrugged apologetically. "We have no way of knowing exactly when Charlie had the stroke. It could have been moments before your father found him -- or it could have been just after midnight. There is no way to predict the success of the tissue plasminogen activator. I'm really very sorry."
Don's face fell and he looked dangerously close to tears. Alan interrupted, mostly to draw the doctor's attention away from his son. "So what happens now?"
The doctor looked at the chart in his hands and sighed. He hated this part. "Charlie will have further studies with an MRI later today. At some point speech therapy will evaluate his ability to swallow. I'm afraid we can't allow him anything by mouth -- not even ice chips -- until we see how that turns out. If he is unable to swallow, we'll have to discuss...the alternatives. Does your son have an Advanced Directive, or Living Will?"
Don's eyes widened as his own sluggish brain processed what he was hearing. If Charlie couldn't swallow, they'd have to put a tube into his stomach and pour food into him for the rest of his life; however long it was. "He's only 31!" he snapped. "Why would he have one of those?"
Again Alan interrupted. "Actually," he said quietly and a little apologetically, "he does. I decided to do one a few months ago and he saw what I was doing. At first he was very upset, but after he calmed down he agreed that it was a good idea. I brought home an extra form from the Senior Center, and he did one himself. He wants intervention, to a point. His brother and I are to confer with at least two physicians to determine when..."
Alan couldn't go on any longer, both because he was having trouble with the topic and because Don was leaning toward him, yelling. "What?! Why the hell didn't I know any of this?"
Alan felt the tears gathering at the back of his eyes and hurried to speak. "Son, we both knew that you have one already. The Bureau requires all field agents to do that, right? You've told me that you have to update it annually, just like your first aid training or your weapons qualification. In fact, I reminded Charlie of that and it was one reason he decided to make one of his own." Two fat tears rolled down Alan's face. "He said, 'There's no guarantee for any of us, I guess. I could be hit by a car tomorrow.'" He stopped speaking for a moment and took a breath, grabbing a tissue from the box on the low table in front of him and wiping at his face. He turned a stoic and composed face back toward the doctor. "I have it in the safe at home. I can bring it in."
Varminni nodded. "That would be best. We can make a copy and keep it on file." He cleared his throat, waiting until Don had settled back in his chair to speak again. "As I was saying. Charlie will have many tests today, yet still needs as much rest as possible. I know this is difficult to hear, but perhaps you should return home for a few hours. Get the Advanced Directive, and maybe a few things Charlie would like. Comfortable pajamas, perhaps." He tried to end the conversation on an upbeat note. "I have been a doctor long enough to see remarkable things, Mr. Eppes. Your son could exhibit a marked amount of recovery in the next 24 hours."
None of the three men said it, but they all heard the same words: Then again, Charlie might not recover at all.