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.She looked into his face. He s beautiful. Apowerful rush of maternal emotion filled her chest. How did I everdoubt that I d love this child? I m sorry I m late, Billie said as she rushed into the room.Cat saw the look of surprise on Billie s face. Cat.I didn t know you d be here, Billie said.Cat extended her hand to Billie. He s beautiful.Introduce me,please.Billie sat on the edge of Seth s bed and kissed him on the head. Hey there, love.It looks like you ve got lots of company today.Tara is here to see you.Cat and Doc are here, too.Doc is Cat s dad,and he s a surgeon. Billie lifted Seth s hand and put it inside one ofCat s. Scout, this is Cat.She s Tara s mom.She s the one I vebeen telling you about.Cat, this young man is my son, Seth. Hi, Seth.You re even more handsome than your mom saidyou were.I m very happy to finally meet you. Cat felt Seth sfingers flex inside her hand.She looked quickly at Doc. His fingersare moving. She addressed Seth once more. Seth, I m going to60turn the television on so you and Tara can watch cartoons whileyour mom and I talk to Doc.After that, Doc wants to examine you.* * *Billie and Cat sat in chairs across from Doc.Billie s handsshook nervously.Doc squeezed Billie s shoulder. Relax.I ll explain what Ifound when I reviewed Seth s charts and what my exam told me,and then I ll go over the tests I think we should run. Doc releasedhis grip on Billie s shoulder and sat back. All right.There s noeasy way to say this, so I ll be direct.I ve reason to believe Sethwas misdiagnosed nine months ago.Billie jumped to her feet. What? Those bastards.Doc folded his arms across his chest. I understand your anger.Sit, and I ll tell you how I came to that conclusion.Billie sat down and folded her hands in her lap to hide thetremors that ran through them. I m sorry. No reason to be sorry.I d feel the same way if it were one ofmy girls in Seth s position.Like I said, I think he s beenmisdiagnosed.I base this on a couple of things.First, just as youdescribed, we ve seen his response to Tara.Second, his recordscontain the results of testing which measure responses to appliedstimuli.The first test is called the Glasgow Coma Scale.It s basedon a fifteen-point scale.The lowest score a patient can receive iszero and the highest is fifteen.It estimates the outcomes of braininjury in the areas of motor response, verbal response, and eyeopening.A score of one indicates no response.The higher the score,the more interactive the person is.With a diagnosis of persistentvegetative state, one would expect a score of less than three, whichmeans absolutely no reaction to stimuli.Seth s score was a five. Five doesn t sound like a very high score. It isn t, but it s significantly better than I expected.What thisultimately means is that Seth isn t in a persistent vegetative state.Before we discuss that in more detail, let me tell you about oneother test result that supports the misdiagnosis theory.It s called theRanchos Los Amigos Scale, which measures the levels ofawareness, cognition, behavior, and interaction with theenvironment.There are eight levels of awareness, beginning with noresponse at level one, to purposeful and appropriate response atlevel eight.Again, persistent vegetative state would be an accurate61diagnosis for level one.Seth s test results nine months ago indicateda level two, which meant he had generalized response. So what does this mean relative to his recovery? Billie asked. Unfortunately, it means we re starting over.If he d beenproperly diagnosed nine months ago, his doctor would ve ordered amore appropriate rehabilitation program than the one he underwent.Since brain injuries can become worse with time, we ve lost thebenefit of early treatment.Because of the nine-month delay and theimproper treatment program, it s possible he s sustained damagethat s now irreversible. Are you saying his doctors are right, that his condition has nochance of improving? No, I m not saying that at all.His treatment plan wasappropriate for someone with persistent vegetative state.However,he s demonstrated response to stimuli that clearly shows that s notthe case.The fact is, he is responding to stimuli.Where there sresponse, there s hope for treatment.Billie smiled through her tears. I don t know what to say.Ihaven t had any real hope for nine months. Hope is one thing we definitely have, Doc replied.He rose tohis feet. I ll order the appropriate tests before I leave today.Cat labored to her feet. Obviously, we need to re-baseline himwith a repeat of the Glasgow and Ranchos Los Amigos tests.I dalso recommend an EEG as well as a CT scan and MRI, she said. My thoughts exactly, Doc said. The best scenario would beto uncover a specific reason for his lack of consciousness that iscorrectable rather than general brain damage that may require moreextensive rehabilitation.I ll go order the tests for tomorrowmorning.I should be back shortly to do a physical exam.Doc left to set up Seth s tests.Billie took Cat s hand in her own and squeezed it lightly. Thank you. Billie, I don t know what I was thinking.I took one look athim and realized there was no way I could resist falling for him.Tara wants Seth to be her big brother.And I want him to be myson. Yeah.Can Seth come home to live with us? Tara asked fromher position on the bed.Billie fought the tears that threatened to fall as she smiled atCat. Do you mean you want us to be a family? I m saying I want us to be whole, all of us, beginning withSeth [ Pobierz całość w formacie PDF ]