The chaplain greeted them and prayed with them before heading up to the Intensive Care unit. Unexpectedly, he took them into a conference room rather than right to Ryan's room. "Don't worry," he said. "The staff is still getting Ryan settled in, so they asked me to orient you a bit before you go in. An ICU is a very strange place when you aren't used to it."
"What do you mean?" Mrs. Kelly asked.
"Well, for one thing, most people expect ICUs to be quiet. They rarely are. There is a lot of activity, and every patient has multiple monitors, all of which have different alarms. Some are simple things, such as indicating that an IV bag is empty or a machine is running low on battery life; others are urgent indicating potentially life-threatening conditions. You'll learn which ones you should worry about and which are minor, but it will sound quite confusing and can be frightening at first. The nurses will be more than happy to answer any questions you have and help you understand them; please don't hesitate to ask.
"I also need to prepare you for what Ryan will look like when you see him. As you'll expect, he's been changed into a hospital gown and has an IV running, but there are other things as well that you need to be ready for. He has a number of monitors attached to him that are constantly measuring and recording his heart rate and blood pressure and the oxygen level in his blood. There is also a monitor attached to his scalp, which runs to a sensor that has been inserted through a tiny hole into his skull to allow the staff to directly monitor the pressure in his brain. This is vital information; as you know, the skull is essentially a sealed box. When someone has a brain injury and is bleeding into that space, the skull can't expand, so the pressure builds up and can cause even more brain damage than the initial injury. This monitor will let the staff know if Ryan needs more aggressive treatment, such as medication to reduce swelling or surgery to remove some of the excess fluid.
"There are two other major things. One is a nasogastric tube, a thin tube that runs down his nose into his throat and then to his stomach; this allows the nurses to feed him a liquid mixture similar to baby formula. The other is the ventilator tubing, which enters his mouth and goes down his windpipe to his lungs."
Ryan's family looked at the chaplain and each other. This sounded terrifying, like a nightmare.
"I know," the chaplain said soothingly. "It will be quite startling when you see him, and I know it sounds quite bad, but it would be far worse if you'd just walked in and didn't know what to expect."
"I expect you're right," said Mr. Kelly. "I know the doctor said that only one or two of us could stay with him at a time, but would it be possible for us all to go in together the first time?"
"Yes, that won't be a problem," the chaplain said. "You all won't be able to stay long, but there will be no harm with you all going in initially. Ah, and here's his nurse this shift, Fiona. Fiona, these are Ryan's parents and brother and sister."
"I'm glad to see you all," Fiona said. "Even though Ryan's in a coma, there is good evidence that coma patients can hear what is going on around them. Having familiar people around seems often to be a helpful thing. Feel free to talk to him as much as you like - tell him the news, what's going on with the weather, or anything else you can think of. You don't need to talk constantly, but let him know you're there and that you won't leave him." She led them out of the conference room into the Intensive Care unit proper.
There were separate rooms, but most of the front wall of each room was glass so that the nurses could see their charges from the central station. Fiona led them to the second door on the left. She paused outside. "He tolerated the move up here, getting him into bed and all the monitors getting set up well, " she said. "He did respond to some of the procedures that were a bit uncomfortable, by grimacing or tensing up; that's a good sign that some information is getting through. Do you feel comfortable going in on your own, or would you like me to come in with you?"
"I think for the moment we'll go in on our own," said Mr. Kelly.
"Of course," Fiona said. "Don't hesitate to call me if you have any questions. I only have Ryan and one other patient to take care of, so I should have plenty of time if you need it."
They thanked her, and stepped into Ryan's room. They'd been able to see him from outside, which was both comforting and disconcerting, seeing him with the machines the chaplain had described hooked up to him. They gathered around his bed. They all looked at each other, not sure what to do. Mrs. Kelly solved the problem.
"Hello, dear," she said. "It's Mam, of course. Da's here, and so are Raymond and Colette. At least one of us will be with you all the time." They all spoke to him briefly, so that he could hear each of their voices. It was horrible not seeing any response, but they had to believe that he understood them.
"One thing I do want to talk about," said Mr. Kelly to the rest of the family, "is something that I discussed with Sharon. She's asking most of the CT family not to come here, but we agreed that we aren't going to be able to keep the other lads away. I'd imagine they could be arriving any time in the next several hours or so. What do you all think about seeing if the doctors will let them in with us? They are certainly as close as brothers to Ryan, and if he can be comforted by hearing us around him, surely their presence would be a comfort as well."
"I'd like that," said Mrs. Kelly. "They're all such sweet boys, and I think it will make it easier on us as well, don't you?"
"I do," said Mr. Kelly," but I don't think that argument will hold much ground with the doctors. Ray, Colette, what do you think?"
Ryan's brother and sister agreed wholeheartedly. They knew that Ryan was used to contact with the other singers, and that they were an integral part of his life.
"All right," said Mr. Kelly. "Raymond and Colette, will you take first watch? I want to speak to the doctors about this as soon as we can, and then your mother and I can greet the boys as they come and get them up to speed." Raymond and Colette settled in chairs by Ryan's bed, one holding each of his hands, as Mr. and Mrs. Kelly left the room to find Fiona.
They stepped up to the central station. "Fiona, may we speak with you a moment?" Mr. Kelly asked.
"Of course," she said, and led them back to the conference room. "What can I help with?"
"We'd like to make an unusual request," said Mr. Kelly. "I'm sure you were notified that Ryan is part of the musical group Celtic Thunder, one of the singers?"
"Yes," said Fiona, "I've heard them, they are amazing."
The Kellys smiled. "Yes, they are," Mrs. Kelly said. "The four other current singers and Ryan are very close, as are the two who have moved on to solo careers - they are truly like brothers. They spend nearly half of each year living, as they often say, in each other's pockets on tour, and they're hardly out of touch even when they're home. We would like to talk to the doctors about allowing them access to Ryan's room. They are as vital a part of Ryan's emotional life as we are, and we as a family think it would be good for Ryan if they could visit him as well."
"Hmmm..." Fiona pondered. "I can certainly see your point. I will bring it up to the doctors when they do rounds in a few hours - will that be all right?"
"Yes, that'll do," said Mr. Kelly. "Now, I assume there's a waiting area somewhere nearby for people who aren't in the rooms at the time? Could you show us there? We expect the first of the boys to be arriving soon, Keith only lives in Donegal, and Emmet in Mullingar."
