Jake turns his head toward me and I suspect he can hear me. If he can respond, no matter how minimally, then he meets the most important criteria. He closes and opens his mouth arbitrarily, but not a sound comes out. I ask him to lift his head and I wait. Nothing. His mother is quiet and nearly in tears. I ask her to turn off the fluorescent lights and shut the door, and when she does Jake exhales faintly. It sounds like relief, like the hint of a response. I ask Jake once more to lift his head. A good fifteen seconds later, his head slowly raises an inch off the pillow, and then drops back down. That’s criteria enough for me. His mother grins at me proudly, as though her son just won a marathon. In a sense, he has.
The next two hours find me thumbing through a thick notebook of Jake’s medical records, trying to decipher the scribbled progress notes and lab reports, then interviewing nurses and aides and doctors. I spend the last half hour of my evaluation explaining to Jake’s mother that this will take months at a minimum, but most likely a year or two—if anything happens at all. She will be my best resource through all of this, I tell her, as I hand her a list of administrators to call and a few forms to fill out. She tells me she will do this and anything else I ask, but she doesn’t need to say a word. If she’s been through this much already, paperwork and phone calls aren’t going to stop her.
Before I leave, she asks for my business card, not because she doesn’t already have my number, but because she wants to know my title, she wants to know what kind of person drops everything to go to look at a bedridden man four hundred miles away. I hand her my card and tell her I am a brain injury case manager, and there is the hint of a smirk because we both know that brain injuries cannot be managed any more than a thunderstorm can be managed. They can be endured, accepted, and integrated, but not managed. She clasps her hands around mine, and I say goodbye, and I get back in my car. I am forever back in my car. I turn the ignition and hope for home, so I can lie down next to my wife and rest my hand on the warm crest below her navel.
The hope is false; a singular voice mail from my director asks me if I can drive two hours north to Sioux Falls to assess a woman with brain damage due to a viral infection. Either I drive the two hours today, or I drive back home to Tulsa and drive ten hours up to South Dakota on Monday. I head north and can already hear the disappointment in Christy’s voice. When I call her from a filling station outside of Omaha, she doesn’t answer and I leave her a message. My marriage unfolds in messages.
On my way up to Sioux Falls, I think about Jake still lying there in the nursing home, and how he has been lying there throughout the past year while I was buying a house and mowing the lawn and attending parties and traveling. He has been lying there long enough for his wife to have given up hope and file for divorce, and he hasn’t seen his son in months. Jake is trapped in an awful sense of nowhere, and yet he is still present, still responding, still human. I may not be able to help, but I can act. I can act for Jake, which, right now, is more than he can do for himself.
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