August 4 (Saturday night) - midnight

For Jeannette, she continues to hold her own, and her all important numbers are hanging in there.   Still, there are moments of concern, a roller coaster of sorts that makes it still very clear its all a delicate balance where the art of medicine seems to drive the science.    In the midst of it all there is little rest for Sam, but she is on top of things, watching the doctors, asking the questions, and making sure that things said are not lost.    Still, the swings, the ups and downs of the ICU keep everyone on their toes.    It's not like there are big things to report.   But the small things catch your attention.   Jeannette's temperature went up, but then later came back down.   The blood tests and all important white cell counts look good, and to me her color is good and she seems to be resting well.   The staff is there, and if you watch them they will make changes, adjusting a medicine drip, or turning her oh-so-carefully.   Her blood pressure changes now and then, attuned to the drugs she is getting, and throughout the day small changes in the treatment plan are discussed by the doctors, and then acted on.      It's actually an amazing thing to watch, her dedicated medical team on top of it all, the doctors coming by regularly to check on her status and to see how their latest adjustments are working.    Its a fine choreographed team of experts who clearly seem to have a handle on things.   The professionalism of everyone gives me, the casual observer, the sense that she is in good hands.   Very good hands.

For Rich, there is some really great news to report.  He is out of the ICU!   Yes, it's true, he rallied today in every sense of that word, and he's starting to eat more real food and liking it.   In his new surroundings he spent a while playing (yes, that's the right word) with his bed controls, testing the nurse "CALL" button to see if it worked.  Oh, he hit that button not once, but more than a dozen times, and it seemed he was setting off the chimes each time he missed the switch he wanted.    He would try to adjust his feet, or raise/lower his head, but then he would hit the CALL button again instead.   He was getting frustrated with the "frappin bed" but it was a thrill to watch him there, to be able to talk and to converse and to see him doing oh so much better.  At one point he even made the comment that he can fly a jet plane, but he can't seem to run a hospital bed.    My gut feel is by tomorrow he's going to have the bed control thing figured out.

There is ONE VERY IMPORTANT THING THAT THE DOCTORS AND SAM want to emphasize with this good news.   Although Rich is now out of the ICU, he is NOT ready for visitors.   Please do NOT try and call him, and please do NOT try and go by and visit him.   That will come, and perhaps soon, but PLEASE NOT RIGHT NOW.     The reason is that there are things he has indicated he does not want to discuss, and it may be that he isn't ready yet.  I get the sense he is afraid perhaps; I mean he's awake enough to know what is going on, and that he has been in an accident, and he for sure has figured out Jeannette hasn't been in to visit him.  When I asked him if he remembered the accident, he said "No...I've got everything through about mid-July, and then I wake up in the hospital and they are spoon feeding me."  

But then he gets more serious, and says "But, I don't want to talk about it!  I don't want to know anything about it!  Not now.   Not yet."  Sitting there, of course I switch the subject immediately, and talk about the silver salmon that are running.    

Right now we are all being very careful not to ask certain things, and we do not mention Jeannette.   That will be for Sam and the doctors to figure out, and when the time is right and Rich is ready and willing then they will handle that.   I'm guessing he will go in that direction when he is ready.  But clearly, the task of mending his body is only a part of a recovery plan.   His mental state is also an equally important part of his recovery, and right now its a delicate matter, one that the doctors and medical staff and the family are discussing.  How that is handled is as important as any other medical decision.  What is crystal clear is that he is not ready or able to handle a major emotional event right now, and they don't want him to go into shock.  

Consequently, it's not time for visitors.  Someone might mean well, but say the wrong thing, or trigger a memory that might send him in the wrong direction.  Jeannette and Rich are on everyone's mind, and it is difficult to treat them as two different patients, but clearly they are.    I truly hope everyone understands.   As Rich becomes more attuned to where he is and what has happened, this will sort itself out.   It may be that we will wheel him in to see Jeannette, although at this point that would probaby be a tremendous shock.   But perhaps when she reachs a point where she can talk clearly then we can let them call each other.   It is all being discussed, the doctors and professionals clearly with more expertise on this kind of issue than any of us.   But when I am seeing Rich, there are things I do not discuss.  

So, please, no visitors right now, other than the few who Sam has ask to help her walk that careful thread of what to say and how to say it.    That's the reality of where things are.   

My promise though is I will let everyone know when its time to give Rich a call, or when he's ready to take on an onslaught of visitors.   What we will probably do is to try and schedule them, so that we can each sign up for time slots and make sure we do it smartly.   But not yet.  Not now.   So, please just be patient.

I'll close this note tonight with something Sam shared with me, and I think she would feel honored as I share it with you.  Tonight she was with Rich for many hours, sitting with him in his new room, talking with him and holding his hand on the arm he had broken, gently rubbing his fingers and talking with him about different things.  She was there when he was working the bed controls, and apologizing to the nurses when he would "ring" them again.  And again.  

Then, at one point sometime later, while Sam was massaging his fingers and soothing him, he started to tell her how much he appreciated what she was doing.    He told her how good that made him feel, that it "helped lower my blood pressure" and it was clear that he relished her attention and love.  

It was a personal, private time, a bonding in a way that perhaps might not have ever happened except for this terrible accident.    While Sam would readily admit she would much rather be sitting with a healthy Rich talking about grilled brauts and gourmet food and joking about the next salmon run, nevertheless, the moments they shared today will be special memories she will hold dear for the rest of her life.  

And so, with those thoughts and this news I think it's a good way to end tonight's update, and a good reminder and lesson for the rest of us.   Don't be afraid to get close to the people you love.