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Re: Informed consent AU M/L ADULT 4/27/2009
Posted: Fri May 01, 2009 2:59 am
by greywolf
They started their usual job of fixing up Liz. Despite the best efforts of the rehab center, the girl had lost a lot of weight. Unused muscles just seemed to evaporate, Maria understood that, and it had happened gradually over the past months. Even so, Liz looked so small and fragile there asleep in the bed. Pale, too. Maria found herself wondering when the last time Liz's body had actually seen the sunshine. She was getting Vitamin D in her tube feedings to offset the lack of sunshine, Maria knew, but it certainly didn't do anything for her too-pale skin. She had a new IV poked into the back of her left hand.
'The girl looks like an anorexic who's been worked over by a vampire,' Maria told herself. 'Surprisingly enough, the truth may soon be almost as strange....'
Maria started the usual routine, helping Izzy with the shampoo. The girl seemed so - normal - just washing Liz's hair. But as Maria reached for the hair-dryer, her mind went back to the events in the room this morning - then back even further - to the first time they'd done Liz's hair together.
Isabel had been awkward with the hair dryer - almost as if she'd never seen one before. She still wasn't particularly good with the thing - Maria usually did the drying after the shampoo and she now realized that Izzy's awkwardness with the hair dryer was why. 'Yet the girl's own hair is like that of a fashion model,' Maria told herself, as she gave Isabel a lame smile.
She watched as Isabel applied a light touch of cosmetics from her cosmetic case. It drastically improved Liz's pallid complexion. 'Of course, that color of blusher wasn't in that cosmetic case when I looked at it earlier...,' Maria told herself.
"Izzy," said Maria, trying to keep the trembling from her voice, "... you and Max seemed to be hanging around with Michael Guerin an awful lot - at least until recently. Why him, of all people?"
The words caused a brief spasm of guilt to go through Izzy. In fact neither she nor Max had been seeing much of Michael recently. Max's trip to Albuquerque and his court issues - constantly dreamwalking Liz - her own budding romance with Alex -'still haven't figured out how to break the news to him, either...,' But she and Max had been hanging with Michael since the fifth grade and they had long ago established a viable cover story. She repeated it automatically.
"We have a lot in common with Michael."
"You do? What would that be?"
"All three of us are survivors of the state department of child welfare. We are all foundlings."
"That's an interesting coincidence. Michael never mentioned that to me."
"Well, Michael's not exactly what you'd call communicative."
Maria nodded sadly in agreement, You got that right..."
"It's not his fault - not really. I sometimes look at Michael and wonder what I'd be like if I'd spent almost five years in that system. Max and I were fortunate. Mom and Dad found us walking along the road and picked us up. We only spent a few weeks in custody of child protective services - just until they could check mom and dad out so they could foster us - then adopt us after we went unclaimed for long enough. It was far worse for Michael."
"You got that right. Child Protective Services - Hmphh - did you know that Hank Guerin beats him sometimes?"
"He does what?" asked Isabel, turning to look directly at Maria. Maria felt the hair stand up on the back of her neck. Isabel's appearance hadn't changed - except for the eyes. The eyes looked - lethal. "Say that again, Maria..."
"Oh, about four months ago - the night of the big thunderstorm - I saw Michael out in the wind and rain. I pulled him in out of the rain. He had - bruises. Apparently old man Guerin was drunk and wanted to go out and get more liquor. Michael wouldn't give him the car keys so the old man flew into a drunken rage and tried to pin him in the trailer until he could get the keys away from him. Michael wouldn't give them up, and got slapped around pretty good by the old man before he could get away. What I don't understand is why Michael didn't fight back. He's at least as big as his foster father. Or failing that, just tell someone?"
Isabel's eyes softened. "Like I said, Michael isn't much for communication. And as for fighting back - sometimes Michael doesn't know his own strength or at least - doesn't control it that well. He was probably afraid of hurting someone. Anyway, I'm glad someone was there for him that night. He isn't as tough as he pretends he is. He isn't even as tough as he thinks he is, actually."
"I guess," responded Maria.
At that time there was a soft knock on the door and the girls looked up to see Jeff and Nancy Parker and a nurse.
"They have to take Liz down for her initial evaluation - do you want to come to lunch?" asked Nancy Parker - her husband nodding beside of her.
"Sure, " said Maria, combing out her best friend's hair. "we are almost done."
"She really does look beautiful, girls," said Jeff Parker. What you two do just transforms her. She almost looks like - well, like before any part of this nightmare happened."
Within minutes, the four were off to the hospital cafeteria.
Re: Informed consent AU M/L ADULT 4/30/2009
Posted: Sun May 03, 2009 4:04 am
by greywolf
- It was 4PM when Mr. And Mrs Parker, Isabel, and Maria assembled in the small conference room to hear the results. They had just gotten seated when Dr. Worthington entered trailing behind a white jacketed man who appeared to be in his mid-Sixties. But it was Dr. Worthington who first stepped to the small podium that was sitting at the end of the table. She loaded what appeared to be a CD in the notebook computer next to the podium and looked up.
"I would like to introduce all of you to Doctor Peter Hanshaw, MD, PhD, the director of the Neurological Institute, the Medical Principal Investigator of this study, and last but certainly not least, my boss."
She turned slightly toward the man and said, "Dr Hanshaw, this is Mr. and Mrs. Parker, as well as two friends and classmates of their daughter Liz, Maria DeLuca and Isabel Evans."
"Thank you, Sara. I am pleased to meet all of you - although certainly I regret the necessity for you to have to even consider having your daughter participate in this study. Before I give your daughters results, I wish to give you just a little background of the goals of this study. We are attempting to develop treatments that will improve the fairly wretched recovery rates for those individuals who - due to traumatic injury - are found to be in a chronic comatose state, refractory to more conventional treatment. As such, our concern is the process of science. It is not that we do not care about each and every one of our research subjects - we certainly do - it's simply that our goal is to further the course of treatment for society itself. Nonetheless, our Institutional Review Board insists - and I believe that is a good thing - that we inform you at the outset that we are not primarily treating these subjects for the good of the subject, but rather for the good of society as a whole. That causes certain ethical issues that need to be discussed.
We would certainly not provide our subjects with less than the best treatment we are capable of providing but having the technical capability to do something does not necessarily mean that it should be done. The decision of the appropriateness of the treatment - considering the likely outcomes - is a decision more appropriately left for the patient in most normal studies. In this case since all patients meeting criteria for entry into the study are by the nature of their injury incapable of giving informed consent, this information is passed on to their spouse, parents, or others that are entitled under the appropriate federal and state laws to give that permission. Not everything that science can do - even though it contributes to the advancement of science - is necessarily something that the patient involved would consider a good outcome. In this case, you are the ultimate arbiters of whether or not your daughter would desire treatment, giving the probable outcome."
"That sounds rather ominous, Doctor," said Jeff Parker. "It sounds like bad news."
"For our purposes, Mr Parker, the precise limb of the research protocol into which the initial screening test places your daughter is irrelevant. The protocol is designed to make apples-to-apples and oranges-to-oranges comparisons. The protocol is stratified for age, Glasgow score, time since original injury, and last-but-not-least, the results of the original screening test. Sara - Doctor Worthington - has given you a standardized briefing on just what neurotrophins can theoretically do, but what they do in practice is based on a variety of factors."
Dr. Hanshaw pushed a key on the small computer and an image was projected on the wall behind him.
"This was the screening study of your daughter's brain after she was injected with the radio-isotope labelled immune globulin. I'm sure you don't routinely read these but let me tell you, the abnormality present is very small, and required considerable magnification to see with any detail."
Hanshaw pushed another key, and a small linear area of increased uptake was barely visible in the midbrain.
"Your daughter has a quite small and precise area of damage measuring less than 6 millimeters by 85 millimeters - call it a quarter inch by three and a half inches, pretty much along the saggital region in the midbrain. Coincidentally, I referred the accident description from the police investigation to Dr. Ken Rhinehart over at the U of Chicago bioengineering department. He has a computer model that predicts brain damage based upon the direction and magnitude of the forces impacting the skull, and this finding corresponds extremely well to his predicted injuries based on that model. That is to say, we believe this actually is a good representation of your daughter's injury. Based upon our results to date, our treatment is most successful for injuries of moderate severity in the cerebrum - where consciousness is disrupted due to a large number of cells being damaged but not killed. Even if some of these damaged cells do go on to die, they are rather readily replaced by neural stem cells stimulated to do so by the neurotrophins. Here is a picture of such cerebral cells. They are -as you can see - a few hundred micrometers apart, and the new cells can fairly easily attach dendrites to adjacent cells to replace damaged cells. On the other hand, this slide is a fair representation of what we would see were we to section through the reticular activating system - if we were to take a cut transversely through the area of damage in your daughter's brain. This is the area that - in the canned presentation that Dr. Worthington gave you this morning - that involved the comparison that were the body of the cell a tennis ball, these bundles of dendrites would be the size of your little finger and stretch a mile and a half - perhaps two miles in this case. The signifigance of that fact is simply this. Effectively, the neural stem mechanism for the replacement of these longer cell tracts simply doesn't work."
"But why not, Doctor," asked Jeff. "I mean, it worked once. You say these cells originally grew from stem cells, same as the cerebral cells, why not again?"
"The problems are multiple, Mr. Parker. For the cerebral cells, the probability that the replacement cells could serve the function of the damaged cells is quite high. They merely have to send out dendrites a few hundred micro meters until they contact the dendrites of adjacent cells. When they do that they fill in anatomically and functionally for the missing cells. Statistically, this is a very likely occurence. In the case of the cells of the reticular activating system, however, the problem is far more severe.
These particular cells must grow several thousands of times farther - and in the right direction at that. Originally, the neural stem cells that created these structures were part of a growing embryo. The distances were much smaller, and during the development a series of genes are activated in a precise order that produce specific neurotrophins - not general ones like we have - that literally guide the embryonic cells to their targets. Even so, it takes several months of embryological development to complete those pathways.
We are only capable of providing neurotrophins for three days - enough to activate the repair mechanisms of the neurons, and enough to stimulate the neural stem cells - but certainly not long enough to allow enough growth of the neural stem cells to permit them to grow this far, nor any particular guidance in their direction of growth even if they did. The probability of any of these cells growing in precisely the right direction without such guidance is quite low.
The neurotrophins will of course stimulate repair of those damaged cells, but that's the only mechanism in which they will be able to act, and that is by far not the mechanism that typically supplies the greatest benefit in this treatment modality.
In summary, your daughter has a very limited lesion, but a very specific one as well, and it is the one that is LEAST amenable to our experimental treatment."
"Does that mean you won't treat her," asked Nancy Parker, tears trickling down her cheeks as she spoke.
"No, that's not the point of this at all, Mrs. Parker. The point is that your daughter has significant damage to a critical area rather than more general and less severe damage. I'm frankly surprised that she hasn't deteriorated further already. Now for purposes of the study, that's really unimportant. We do, as I say, make apples to apples comparisons. For the purpose of this study it is still valuable to know if treating Liz, assuming the next test shows a possibility for benefit from that treatment - gives a significantly better result in comparison to not giving that treatment. The point for your purposes is that it may give a statistically significant result and still not lead to what - from a clinical standpoint - we might consider a practically beneficial standpoint."
"I'm afraid we still don't understand, Doctor," said Jeff Parker.
"Let me give you a different example and see if that clarifies things, Mr. Parker. If we are to look only at short-term improvement, between five and ten percent of our patients get an immediate increase in function from a direct stimulative effect of the neurotrophins, regardless of whether they receive any long term benefit or not. Typically we don't count this in our findings because it provides no long-lasting effect. The clinical subject may have a few minutes of consciousness - may be able to recognize and even converse with people - but this particular stimulative effect is only temporary. Five hours later, most of these subjects are no different from the pretreatment state. One might say that being able to briefly say goodbye to loved ones might be a benefit, but it is clearly no long term benefit, and even the short-term benefit might be arguable. In the absence of the possibility of long term benefit, is it a kind thing - an ethical thing - to awaken these people? In the case of your daughter, she is many months since the terror of her accident - but would we be doing her a kindness to awaken her to inform her that - well, she has only a few minutes of meaningful self-awareness left?
In your daughter's particular case, there is another issue as well. With the degree of damage she has, even a successful treatment - statistically successful that is - will result in an improvement. It will not bring her back to anything resembling a normal life."
"How much of an improvement?" asked Nancy.
Doctor Hanshaw backed the images up until he was looking again at the magnified version of Liz's PET scan.
"Worst case - of course - no improvement at all. Best case? Well, I would estimate that she would have perhaps sixty minutes of useful consciousness per day - most likely in two or three minute intervals spread throughout the twenty-four hour period. Whether such a life is something your daughter would want -well, that's the ethical question you must wrestle with. If she passes the next test we would certainly give her the treatment if you consent to it because - even this modest benefit - advances the cause of science. Whether or not it advances the quality of your daughter's life is another question - a question that you will have to decide before you consent to the full treatment. The point is that not all statistically significant improvement - even though it advances the cause of science - is necessarily desirable. Particularly if the practical effect is to raise the patient's level of consciousness enough to know just how bad off they are."
As Doctor Hanshaw finished the sentence, tears were slowly trickling down the cheeks of all four of those who had accompanied Liz from Roswell, but none more than Isabel Evans.
'Max and I really didn't consider this,' she thought. 'Unless we really can cure Liz, perhaps it's cruel to even give her hope? No wonder the girl is in denial - thinks we are just part of her dream. If we actually give her hope and can't actually come through for her, it will be crushing.'
Of course, Isabel also knew something the doctor didn't - how miserable and lonely Liz had been when they'd found her in the abyss. Maybe had they not intervened - had they just let her go - it would already be over by now. But they had intervened. Liz had become her friend, and Max - well, Max was well on his way to becoming the lover that he had seemed to be destined to be since that very first day in third grade when he and Liz met.
'No,' said Isabel to herself, 'We need to try. Liz is my friend and I'm not going to leave her in the abyss if there is anything we can do to get her out.'
"Doctor Hanshaw, I think we need time to talk this over and think this all through," said Jeff.
"Of course, Mr. Parker. Until tomorrow, we won't even know if your daughter is a candidate for treatment in any event. You've come a long way, and I'd suggest that you not make any final decisions until you know whether or not treatment is even possible. We would like to treat your daughter, assuming the test overnight shows that she is a candidate for treatment, because it will further the course of science. We will, of course, abide by whatever you and your wife decide."
"Maria - you are Liz's best friend, and Isabel, I know you care about Lizzy too. What I think would be a good idea is for the four of us to meet someplace - have dinner - then each of us talk about what we think Liz would want us to do, under the circumstances," said Jeff Parker, a tearful Nancy nodding her head slowly beside him.
It was then that it hit Isabel. Her and Max deciding to help Liz really wasn't enough. They needed consent from Liz's mom and dad for the institute to treat Liz, or they were dead in the water. Even with treatment the odds were against them, but if she - Isabel Evans - couldn't convince the Parkers to agree to that treatment, there seemed little option but to just watch helplessly while Liz's self-awareness faded gradually into nothingness. The abyss would consume her, and she would be lost forever.
'You've got to convince them, Isabel,' she told herself. 'Lie to them, trick them - do whatever you need to do to give Liz a chance to wake up.... then hope that Max's powers can come through to finish the job.'
Re: Informed consent AU M/L ADULT 5/3/2009
Posted: Mon May 04, 2009 12:38 am
by greywolf
He lay in bed on his left side, her naked body spooned against his, his right hand gently cupping her breast. It wasn't exactly how Jim Valenti had planned to spend the evening, but he certainly wasn't complaining. He had in fact taken Amy out for dinner - only their fourth real date. He had been attracted to her for over ten years - ever since he'd had to handcuff her and carry her out of the lobby of the federal courtroom where she had been protesting - what the hell was it? - Oh yeah, a Fish and Wildlife Service request to take Mexican Free-tailed bats off the threatened species list.
He inhaled deeply - revelling in the scent from her hair. It had been sandalwood oil then too, he remembered. He should have asked her out way back then, but it had seemed a little bizarre to handcuff someone and carry them off to jail like a sack of potatoes and then court them - something like Alley-oop the caveman would have done.
So he'd never done it and he'd gotten used to being a single father raising Kyle with a career in law enforcement and she'd gotten used to being a single mother raising Maria and a small business woman and - suddenly a decade had gone by and they were both still single and neither had ever found anyone.
But the call about Michael Guerin had changed all that. Michael was the same age as his son Kyle - the same Kyle that was off to New Mexico State University for a week for a speed and agility camp sponsored by their athletic department. Something about Amy's obvious concern for the boy - her obvious maternal skills, had led him to start thinking about all that Kyle had missed by not having a mother since his biological mother had dumped them both and headed out to seek fame and fortune in Hollywood. She was still there actually, flipping burgers in a diner in Burbank and hoping for her big break - and good riddance to her.
Amy was the complete antithesis of the woman who had left Jim and a not-much-more-than- infant Kyle. She was kind, caring, and had shepherded her own child through thick and thin. Somehow his feelings had gone from thinking about what Kyle had missed to thinking about what Jim himself had missed, over the sorting out of the foster child scandal and he had invited her to coffee, half-expecting her to tell him she wasn't interested in socializing with a fascist enforcer of the unfair laws of the corrupt establishment - but that hadn't happened. She had accepted and turned out to be delightful company.
Tonight was supposed to have been just dinner, but when the waitress had asked if they wanted dessert, Amy had simply smiled and said that they were having dessert at her house. Jim had eaten two pieces of Amy's award-winning cherry pie, a la mode, and after he'd finished his coffee he had gotten up to leave. He'd turned back at the door in hope of getting a simple kiss good-bye - that's when things got real interesting.
The kiss had lasted a long time - Jim wasn't sure which one of them broke first, but he knew he'd better get out of ther before he made a fool of himself by pushing Amy farther than she was ready to go. Apparently he'd again misjudged her. She'd told him he couldn't possibly go yet - he hadn't finished his dessert - and led him by the hand to the master bedroom before turning to face him and letting her body melt in to his.
And that is how he found himself an hour later in a room lit by a single flickering candle, naked, spent, and incredibly happy, cuddled up to her spooning body while his right index finger traced gentle circles around her areola.
"Mmmm," he said. "That was wonderful - even if I am out of practice."
She snuggled back against him and turned her head to look back to look at him, a smile on her face. "I'm out of practice too. I hope I didn't disappoint you."
"Did any of the sounds I made in the last hour sound even remotely like disappointment, Amy?"
"No, I guess not. But you know, Jim, they say practice makes perfect. Since we are both so out of practice, perhaps we should - uh - brush up on our skills again. Then maybe just cuddle until morning, since neither my daughter nor your son are in town for the next couple days...."
"That would be a lovely idea, Amy. I'd enjoy that very much. I hope you know - I love you."
"I love you too, Jim," she said as she turned to face him and he felt her lips on his, her tongue pushing insistently for entrance....
Across the street and down the block a dirtbike started up. He'd told Maria that he'd watch after her mother, but it was obvious from the flickering candlelight in Amy's room that the Sheriff was already doing that. Maria had told him about her mother's first meeting with the sheriff, and he'd had his doubts that their dates would ever lead anywhere. They were so different - their very philosophies so alien to one another. Obviously he'd been wrong about that, the same as he'd been wrong fearing Jim Valenti all his life. The man had certainly had bent over backwards to help him.
As Michael rode away he could almost picture Jim and Amy in the darkness. 'Bet he doesn't have any trouble communicating with her - telling her he loves her,' said the voice in his head. Perhaps not, but Jim Valenti wasn't an alien either. How could he ever tell Maria he loved her and then have her find out something like that? Not only would she freak, but she'd stay as far away from him as possible - like leaving for Canada or something. 'Or is it just that I'm afraid - so afraid of losing her I'm not willing to trust her?' he asked himself. He rode off into the darkness - he thought he might go off in the desert and just do some thinking. It wasn't like the trailer and old Hank were worth going home to anyway. 'You simply have to tell her,' Michael, said the voice in his head. 'Let her know that you love her, and the alien stuff won't make any difference.' He heard the voice in his head - loud and clear. He just couldn't get his mind to believe it.
It was 10PM in Chicago and the discussion had been going on for over three hours. After the meeting at the medical center, Isabel had returned to the hotel with Maria and the Parkers. She'd gone upstairs briefly to tell Max what had been discussed at the meeting with Doctor Hanshaw, and no doubt Max was already on his way to the medical center to try to assure that the test Liz was undergoing was read as positive, whatever the reality. They didn't need for Liz to actually benefit from the treatment long-term, if she could just wake up briefly and Max could use his healing powers - well, Isabel could only pray that that would be enough. But that was just part of the problem.
They had talked about Liz over dinner, and the conversation had continued as everyone had gone up to Maria and Isabel's room. It hadn't been easy and there had been a lot of tears.
The Parkers had clearly suffered for over nine months now, but the discussion by Dr. Hanshaw had brought the issue of their daughter's quality of life and continued existence into a sharper focus than it had been since the first days after the accident. Always before there'd been hope, but in a very real sense the treatment at the institute was her last hope - and it was apparent that treatment certainly was no unmixed blessing.
The Parkers had discussed - seriously - not even consenting to treatment, and had Isabel not known what she did know - that Max was waiting in the wings with his healing powers, Isabel wouldn't have honestly blamed them for refusing treatment. What kind of life would that be, for a girl not yet seventeen, to live her life in two or three minute intervals of consciousness spread throughout the day? To be able to only dabble in the superficialities of life, never really having time to do anything meaningful? Isabel wasn't at all sure that she would have wanted such a life for herself.
But Isabel did know about Max waiting in the wings, and at least the hope that he could do ...something. If he could stabilize the torn membranes - save the cells - at the very least Liz could be kept alive in the abyss where she and Max could visit her. Sixteen years were so few - it wasn't fair that Liz wouldn't have the chance to see and do all the things that she'd been preparing for her whole life. It wasn't fair, now that Liz and Max had found each other, that they should now have to part. There was a chance - with Max's powers - a chance for real improvement that was far greater than what Doctor Hanshaw considered possible, Isabel knew that. She'd even considered - briefly - telling the Parkers about her and Max and their powers. She would have, too, if she'd thought it would do any good, but she doubted that was the case.
The Parkers - particularly Nancy Parker - were totally stressed out over this -which of course was understandable. Adding revelations about aliens who visited their daughter through dreamwalks was unlikely, in Isabel's opinion, to decrease that stress, or to even lead to them doing anything other than calling the cops. They already thought Max was some sort of a pervert stalker - the whole story - that he was a part-alien who was hopelessly in love with their daughter - would have freaked them out even more. So finally she had an idea. 'Lie to them, Isabel, just flippin' lie!' she told herself.
'I mean, what the Hell? - your entire life is a lie anyway. Make up some whopper that will convince them to consent to that treatment. The Hell with all this informed consent, nonsense,' some voice deep inside her told her, 'the end - if you can get Liz back - justifies the means.'
The discussion by Doctor Hanshaw had affected Maria as much as anyone. She'd known when they came that this was Liz's last chance, and now the whole thing seemed so - hopeless. Maria honestly wondered if she would have wanted to go on if she could only live life in two or three minute increments.
'Like some flipping movie trailer, but never getting to actually do the movie,' Maria thought. That's when Isabel interrupted everyone's thoughts....
"You know, I had this conversation once with Liz in our seventh grade science class .... Liz loved science so much .. anyway what she told me was that if she accomplished nothing else with her life, she wanted to further the cause of science. She wanted to push back the frontiers of knowledge. She even talked about donating her body to science some day, if that would help medical research. You heard what Doctor Hanshaw said - even if Liz doesn't directly benefit, it will help future generations of patients. I don't think there is any doubt that Liz would want to be part of this study, if she could tell us her true feelings."
Maria looked at Isabel, not quite believing what she was hearing. The girl was lying through her teeth. Isabel hadn't even taken seventh grade science with Liz - the science class Liz had taken had conflicted with the PE period that all of the cheerleaders were in - and Isabel Evans had been a cheerleader. In fact, Maria wasn't at all sure that Isabel had taken a science course at all in the seventh grade....
"You really think that's what she'd want, Isabel?" asked Nancy Parker.
"I don't think there's any doubt of that, Mrs. Parker," said Isabel.
"What do you think, Maria?" asked Jeff.
It seemed like a thousand thoughts and fears were fighting within Maria's head. There was only one way that this made sense - which of course made no sense at all. But as the silence dragged on, Maria knew she had to make a decision - a decision that might haunt her all of her life.
"I think that Izzy's right," said Maria. "In fact, I remember that day - I was there when Liz said that to Izzy," she lied. For good or bad, and Maria wasn't sure which, she'd decided to throw in with Isabel. She hoped it was the right decision.
"Well, if it's what Liz would want, I suppose that decides the matter," said Jeff, Nancy nodding slowly.
There were more tears and a lot of hugging, and then the Parker's left to catch a cab back to the hospital. All at once there was just the two of them in the room, and Isabel saw Maria looking at her strangely.
"I know that you know I lied, Maria," said Isabel. "Thank you for backing me up about that. though. I really do think treatment is the right decision for Liz, and I wasn't sure they were going to make it."
Maria sat on her bed and looked at her roomate, gathering her courage. "I don't want your thanks, Isabel, I just want to ask you one question, and I want the absolute truth from you this time, alright?"
"OK." Isabel said, wondering just where this conversation was going.
"If Liz really does get back to some degree of consciousness ... can Max REALLY heal her?"
The world seemed to spin around Isabel. 'Where in hell had THAT come from?' But before she could think of what to do she heard a voice say, "Yes, Maria, I'm pretty sure he can..." It took her a few seconds to realize the voice had been her own.
But Maria kept asking even as Isabel's mind was trying to cope with her not understanding how this was happening....
"...and that would make you... and Max... and Michael... aliens?"
Through the chaos her mind had suddenly become Isabel heard herself speak, "We think we are alien-human hybrids, really..."
"From the 1947 saucer...?"
"We were in suspended animation... inside of.."
"Pods," Maria finished. "You were stored in pods..."
"How did you find out?"
Maria pulled her knees up to her chest and placed her hands over her face, shaking her head like she was trying to wake up from a dream. Then she looked up at Isabel.
"Michael talks in his sleep."
"Michael talks in his sleep? But omigawd, that means that Hank Guerin must know..."
"I really don't think so."
"But if Michael talks in his sleep, he'd practically have to..."
Maria rolled her eyes skyward. "Look, Isabel. the talking in his sleep part is sort of metaphorical. When I pulled Michael in from the rain that night I put him next to me because he was freezing in his wet clothes. I held him in my arms as we slept and I had this - well this weird dream that he was telling me something about a cave and pods.
I barely remembered it the next morning, but I've had that dream - or ones like it - very vividly three times since then. In those dreams, Michael was telling me this story about the three of you being born in a podchamber, and about your powers - healing -dreamwalking - powerblasting - and everything. I kind of thought it just was a dream ... until all the pieces fell together."
"Michael must have accidentally dream-walked you - but that makes no sense whatever," Izzy said, shaking her head. "Michael's ability to dreamwalk is less even than Max's. How close were you those other times?
Isabel watched the redness creep slowly from Maria's clavicles up to her face as the girl looked up at the ceiling in obvious embarassment.
"The first time ..... after the night of the storm, that is - well, we were separated by a couple of molecules thickness of latex, at least in a certain limited area. Since then - well, I've been on the pill and we were .... quite close."
"You had sex with Michael?" asked Isabel, Maria wasn't sure if the question was in disbelief or in anger, "Well how was sex between a human and an alien-human hybrid?" Isabel continued.
"Oh alright I guess... nothing special. Isabel, honest, I didn't know, OK. He didn't tell me he was an alien or your mate or anything. I didn't intend to upset you."
"Upset me? Mate? Michael? Omigawd, Maria, Michael is like another brother to me. It would be almost as bad as having sex with Max. I was actually wondering how it would be with...."
"With? ... You mean with Alex? That's why you asked?"
Isabel didn't seem to be able to find the right words. She just blushed and nodded.
"Well, in THAT case, let me rephrase my answer. In fact, I don't have any basis for comparison, I mean Michael is the only one I've ever . you know...," Isabel nodded her head. Obviously she did know. '..anyway,' continued Maria, it was sort of - well .... awesome, incredible, wonderful, astonishing, beautiful, magnificent, stunning, overwhelming - pretty much like that anyway. Are you seriously contemplating actually doing it with Alex?"
"I'm not just sure," replied the girl named Izzy who Maria was realizing was going to be her lifelong friend as they smiled at one another. "I've dreamwalked Alex and his dream is for us to have children, and I'm not at all sure that would even be physiologically possible, even if the rest works fine."
"Whoa, well don't expect me to break any trail for you in that department. It is painfully obvious that as much as I care for my Spaceboy we have WAY too many communication problems to take our relationship to that level any time soon. Why couldn't he have just told me about this? I wouldn't have freaked, this is Maria here, not some hysterical girl who would have gone screaming in terror."
"Oh God, Maria, I'm so happy Michael has found someone who cares for him. He needs that, he's had such a crappy life. Max and I were cared for by mom and dad almost from the day we got out of our pods, but Michael was in that damn foster care system where they just warehoused him until they fostered him out to old man Guerin. Except for Max and me he's never had anyone he could talk to - or who cared for him until you came along. He's never really had the opportunity to communicate with anyone - I'm honestly not sure he knows how."
"So what you are saying if I read you correctly, Isabel, is that my only chance to have a meaningful conversation with my Spaceboy is in my dreams - and then only after we have had passionate alien-human sex and as we lay with our intertwined bodies plastered together by sweat and - uh - shared bodily fluids."
"I'm afraid that may really be the case,Maria," said Isabel patting Maria on the elbow in an attempt at consolation. Maria stared off at the wall, her eyes unfocused for a moment before her face took on a quirky smile.
"Ok," said Maria, "...for the time being at least, I think I can live with that."
Isabel seemed to develop a case of the giggles and it obviously was contagious, because Maria soon had them too. As they hugged each other, Maria continued. "Eventually though, I'm going to have to civilize that boy."
"Good luck with that," replied Izzy. "I've got my own problems deciding how to break the news to Alex that his dream-girl actually does love him and that - oh yeah - she's not from around here."
"And we still have Liz to worry about."
"That we do. Hopefully Max is finding a way to help her right now."
Re: Informed consent AU M/L ADULT 5/3/2009(2)
Posted: Thu May 28, 2009 12:07 am
by greywolf
- Ken Hart was a senior technician in the radiology department and over the years he'd seen a lot of things. One thing he hadn't seen - until this morning - was someone from food service pushing a cart into his work area. He didn't recognize the food service worker - not that THAT was a big surprise. The Medical Center was huge and its staff was split to cover 24/7, 365 days a year - it was impossible to know everyone. Besides, the food service worker looked real young. He could only be a new-hire.
"I think you are kind of lost, fellow," he said to the amber-eyed youngster.
"Uh - not really, nuclear imaging, isn't it?"
"Well, it's nuclear imaging sure enough - but I still don't think this is the place you want. We don't have inpatients that require feeding here - as a matter of fact, we only have one patient here and she's being tube fed back on the ward. The rest of us worker bees just walk down to the cafeteria ourselves - at least when we have time."
"Well, food service is sampling new items that we are thinking about putting on the cafeteria menu and your department came up in the drawing we did to see who would get free samples."
Ken Hart looked at the food on the serving cart. There were three kinds of desert he recognized from the cafeteria - and a box full of cupcakes that he recognized from Molly's, a specialty bakery up on North Clark Street. Ken LOVED Molly's cupcakes.
"Nice try kid," Ken said, snagging a coconut frosted cupcake. "But I think you are bullshitting me. Damn good cupcakes though. So what's the REAL story?"
"Look," said Max, trying to put on his most innocent face,"...I'm working nights here in the kitchen, saving money to go to college. What I'm really interested in is nuclear stuff. Did you know that the nuclear age began right here in Chicago? Enrico Fermi built the first nuclear pile in a squash court right under the stands at Stagg Field at the University of Chicago back in 1942. I just got off my shift and I have always wanted to see how you guys do nuclear imaging. I think that would be so cool - so I got some leftover desserts and bought some cupcakes and came here hoping I could get someone to show me around? I won't be any trouble - really."
Ken Hart smiled. The kid looked so young and so excited. Like anyone else, Ken did enjoy talking about his work - especially to an enthused young kid. "OK, but you can't get in the way, and if we get busy we'll have to shoo you out of here. You understand?"
Max smiled and nodded.
"And one other thing - anything related to patient care - like the girl we are going to start imaging soon - you can't tell anyone anything about it - as a matter of fact don't even admit to anyone you ever saw it, OK? Sometimes the family gets real pissed, even if the person is in a coma and doesn't even know you are here."
Max nodded again. He had no intention of letting Jeff or Nancy Parker know that he was seeing Liz have her test - they'd no doubt call the cops immediately. He couldn't afford to be locked up right now - he had to figure out some way to guarantee the test showed the result he wanted. He followed Ken, who started the tour.
What had started as a quick tour wound up taking almost a half hour, and ended right next to the room where Liz was being scanned.
"This is the computer processors for the CAT scanner, the MRI, and the PET scanners. I have to admit, I'm not geek enough to understand anything about their care and feeding - I just use them. This one is the PET - that is Positron Emission Tomography - machine. Right now we are imaging a patient from the coma study. This is the image we got from her previously," Ken said, hitting several keys and bringing the image up on the computer screen.
"The PET scanner is just finishing up her second scan. As I understand it, you want the second scan - which shows damaged tissue that's viable and can respond to the labeled neurotrophins - to look as much like the original PET scan as possible. You want ALL of the damaged tissue to be capable of being helped by the therapy. For this one - Cripes, she's hardly responding at all - that's too bad cause she looks like a nice kid - anyway for her there is very little tissue responding at all. Now what I do is to burn a copy of this on a CD to send to the Coma Research Group where they'll formally read it in the morning and decide if she should have treatment or not. I don't make that call - even the chief radiologist doesn't - the research group does. But I'd be amazed if they selected her for treatment."
Max fought to take his eyes off Liz. He could see her through the window, but this was the first time he'd physically seen her since Albuquerque. Never very big to begin with, she'd lost a lot of weight and looked so helpless in there that he wanted to just go hold her. But he fought against his need to see her - to touch her - and turned his face back to the discussion.
He watched Ken take a CD and burn both images to it -then run it through the machine a second time to make sure the images were correct. They were. As Ken took the CD out of the machine a second time he picked it up and looked at it.
"Just a regular CD? Not even a DVD or anything?" he asked, looking at Ken while he let his mind probe the molecules of the CD. Isabel could do this - listen to CDs without a machine - and he could too if he concentrated hard enough. Could he change the image? Manipulate the molecules and use the first image as a template for modifying the second image? He thought he could.
"No, just a regular CD," said Ken, "... nothing special at all. After all, it's all a digital image - just ones and zeroes -that's all."
'Yes,' Max thought to himself as he felt the molecules rearrange - copying the digital imagery of the first test and using it to overwrite the second. It would only take a couple of seconds....
"Ken, I've got a problem in MRI...," said a junior tech, sticking his head through the door. "We've got a child head trauma patient to do but his mother says he's got a plate in his head from previous trauma. She doesn't know if it's plastic or metal. What do I do?"
"We'll probably need to get a head x-ray to tell. If it's metal, it'll foul up the image and the magnet in the MRI might even hurt the kid. Let me give the attending a call and get permission," Ken said, walking in to his office.
The second technician went back in to the MRI room where an apprehensive mother was trying to calm a kid with a big bruise on his forehead. As soon as he was out of sight Max put the CD back into the machine and started it - watching the monitor as he did so. It had worked perfectly. The image of the second scan looked identical to the first, but all the labels the computer had put on the second scan - which had been on a different channel of data - were unchanged. It was the perfect solution. As soon as Ken got done with the phone call Max thanked him for the tour and left the department, leaving the altered CD in its little paper envelope that said "Imaging studies, Parker, Elizabeth"
As he left the department he knew it wasn't over. Liz might not even be one of the ones that regained consciousness with the neurotrophins. But he had done all he could think to do. He left the hospital and took the El back to the hotel.
When he got back to the hotel he was surprised to see the lights on in his room - he thought he'd left them off - and the door open between it and the adjoining room.But he was more surprised when he smelled the popcorn and saw Izzy sitting at the table in his room using her powers to pop a bag of microwave popcorn - while Maria DeLuca looked on in obvious amusement. The closing of the door alerted both girls who looked up at him simultaneously.
"Max," squealed a smiling Maria, grabbing his hands and looking in to his face, "... did you do it? Were you able to use your alien powers to rig the test so Liz gets treated?" It wasn't exactly the scene he'd envisioned happening when a human finally found out about his powers. It would be a long time before any of the three teenagers got to sleep tonight.
Back at the hospital another person was running on very little sleep. It was 4AM and Dr. Worthington was way too senior to be pulling night call. But one of the research fellows' wife had given birth three hours ago, and she didn't want the new dad to miss the first few hours with his new son. He was rooming in with his wife down on Wing 2B Obstetrics. Besides, she had felt bad for the Parkers. Doctor Hanshaw was a brilliant researcher, but he had less than average diplomacy and tact. She could tell they had been somewhat devastated by his grim assessment of their daughter's prospects. She had hoped to see the scan of Liz Parker as it was being done, but admitting a new patient had taken that opportunity away from her.
So at 4AM Doctor Sara Worthington - who was getting too old to keep these sorts of hours and was definitely running on too little sleep had peeked in to radiology in hope that she would see something that would bring some small ray of hope to the terrified parents. She punched the computer buttons to call up the test, grimacing when she saw the imaging. She looked at Ken Hart - "Pretty pathetic, isn't it."
"I don't read them, I just take them, but ... yeah, pretty bad. I already made a copy of the results for the conference. It's sitting there on the desk."
Sara looked at the original images on the computer screen and shook her head. "Tell you what," she said, "...I'm going to go double up on the dose of the tagged neurotrophins. Wait until 8AM and repeat the PET scan. Maybe we just scanned her too early. Maybe with a second dose she'll react more favorably."
Ken nodded his head knowingly. It was a violation of the experimental protocol, but Ken had a daughter almost that old. If she'd been injured like that, he'd want her to have a shot at treatment - even if the odds were overwhelmingly against success.
"So what do I do with this one?" he asked, holding up the CD Max had altered.
"Burn it. Make a new one when you get the 8AM results. This last test ... it never happened. And Ken ..... don't ever let Doctor Hanshaw know about this."
"Not a chance, Doctor Worthington. Doctor H - well, he's a brilliant man ... but he's got all the bedside manner of Attila the Hun. Besides, what goes on in radiology at four in the morning stays in radiology ... which reminds me, you want a cupcake?"
"Oh.... someone's made a trip to Molly's," said Sara, picking out a white cupcake with Irish Cream Liqueur frosting. "These are great - thanks."
"Don't mention it, they were a gift from a real nice young kid who will probably some day be a nuclear physicist."
Re: Informed consent AU M/L ADULT 5/27/2009
Posted: Sat May 30, 2009 9:18 pm
by greywolf
- It was 10AM and Isabel was waiting in the small conference room of the medical center for Doctors Hanshaw and Worthington to appear. Sitting beside her was Maria and in front of them were Nancy and Jeff Parker. It was difficult for Isabel to believe how much her world had changed in just the last day.
She and Max and Michael had never believed - not for a moment - that humans could really accept them if they truly knew what they were. They'd never trusted them - none of them - with that secret - not even their own parents. They had been convinced that no human would do anything but fear them - or hate them - but certainly never accept them. They couldn't have been more wrong, she thought, looking to her side where she saw her new best friend.
OK, Maria was a little bit of a special case - what with her being ga-ga over Michael. That certainly hadn't hurt things, and not every human was probably going to be that accepting - although Isabel privately thought Michael would be getting an earful once Maria got back to Roswell about letting the relationship get quite as far as it had without trusting Maria with the truth about himself. Although in fairness, Isabel was privately surprised Michael could even dream about breaking the news to Maria. He must be pretty ga-ga over her as well.
After all the angst of all these months - even knowing that nothing about Liz's treatment was guaranteed, that the odds were still against her even with treatment - it had been great to have someone like Maria that she could really talk to - really hold nothing back. Before Max had gotten back they'd talked - goofed around - she'd demonstrated a number of stupid alien tricks, including a complete color makeover of Maria's hair and nails, making nachos from cheese and chips and popping popcorn with her alien powers. It had been great.
And it had only gotten better once Max had gotten back. New hope for Liz - God they'd all three needed that - and the look on Max's face when Maria had asked him if he'd used his alien powers to fix Liz's test - absolutely priceless. Isabel would remember his expression forever.
Max had explained everything to them - just what he'd done - but also that the odds still weren't in their favor. Nonetheless, Max had shown a visceral sort of determination that seemed to resonate within her. Somehow, Max had truly bonded with Liz during their many dreamwalks. He wasn't going to give her up. It was like he was incapable of giving her up. That was a little worrisome too. She worried that if Liz didn't pull through this somehow, she might also lose her brother.
After she and Maria had gone to bed they still had been unable to sleep for an hour. They'd just lain their in their adjoining beds and talked about the future. Maria and Michael - THAT was going to be an interesting relationship, Miss extrovert and Mr. moody loner - her and Alex - Maria said she just ought to tell him. That was easier said than done, she'd replied. Could Maria picture being told that someone had not only been a participant in all of her dream-fantasies since junior high school? That she too had unrequited love? But, oh yeah, I'm an alien, and I may not be able to have those children you want...? It wasn't like Alex was ready for this relationship. He really didn't know it existed. Maria Had conceded the point. It might be better to come up with a long term plan to break the news to Alex gently.
But mostly they'd just talked about Liz, or at least, Liz and Max. They'd both been hopeful - talking about what would happen once Liz was awake - even though they knew the odds were against her. But it was obvious that both were worried about Max, too. All they could do was hope that it would all work out and gradually - over the course of an hour or so - they'd pretty much convinced themselves it would work out.
They'd gone off to sleep and Isabel had tried - without much success - to bring Maria into the Abyss to see Liz. It hadn't really worked. Isabel had never tried to bring a human along on a dreamwalk before and wasn't sure if the failure was because the Abyss really wasn't a normal orb, or because whoever you were taking along required some alien powers of their own to make it work. Isabel could dreamwalk Maria OK, and help Max dreamwalk Liz with some difficulty. But she couldn't take Maria into the Abyss with Liz. Isabel had explained that to Maria and she'd understood. When she explained it to Liz she got the same quirky smile - Isabel was pretty sure Liz didn't believe any of this, although she was grateful for the company even if her two imaginary friends - particularly so for Max who she seemed to be doing her best to cheer up - or at least to distract. And it appeared to work. For those few minutes holding her in his arms, even Max looked happy.
Isabel looked at Maria - they'd have to both make a show of being relieved when the doctors said that Liz could move on to stage II and actually get the treatment. All they could do then was pray that Liz was one of those who was going to have a period of consciousness after treatment. Max was standing by in the 24 hour a day Starbucks across the street. One of the two of them would stay with Liz from the moment she got the treatment - night and day - and at the first sign that she was becoming conscious, whoever was with her would go get Max. Then it would be a matter of distracting anyone present long enough for Max to get to Liz's room and do his thing. They only hoped it would all be that simple. Unfortunately, they were doomed to disappointment.
It was 10:15 and Doctor Worthington had been waiting for twenty minutes to go with Dr. Hanshaw and have him officially read the test results and then tell the bad news to the Parkers. She never looked forward to this and Dr. Hanshaw was trapped in some emergency department head meeting at the university. He'd finally called and delegated to her the duty of seeing the Parkers and breaking the news - stating he'd be there as quick as he could. It was better than keeping the Parkers waiting, she figured, and would undoubtedly be less traumatic than the blunt manner of Doctor Hanshaw. He was indeed a brilliant man, but a professional lifetime of doing research on people in coma and never developing any real people skills? .Maybe you had to be insensitive to survive the pain of this that long. The crushed look on the family when you told them there was nothing that could be done. Sara hoped not. She didn't want to become like Doctor Hanshaw. She didn't really want to tell the Parkers about this test either though, but at least she could do it a little more gently than Doctor H. She knocked twice on the conference room door and slipped inside.
"I'm sorry to be late - Doctor Hanshaw usually gives this presentation, but he's tied up in a meeting at the University and will be delayed. Rather than have you continue to wait on pins and needles he told me to go ahead and let you know how the tests came out on Liz."
Maria and Isabel exchanged glances. At last. They'd watched the Parkers sit there for the last 25 minutes on the edge of their seats, almost hyperventilating, and hadn't been able to tell them anything. Now at last Doctor Worthington could put their minds at ease.
"I'm sorry to say this but your daughter's tests did not come out as wwell as we were hoping. This is your daughter's initial localization of her damage PET scan that we did yesterday. This is the tagged isotope one we did last night... As you can see, there is negligible uptake of the radio-labeled neurotrophin. Actually, I was on duty last night and stopped by and read this right off the computer - didn't even wait for the CD on it, because I was hoping so very much that Liz would be a good candidate for treatment. We even did a THIRD PET scan after I gave her a second dose of the labeled neurotrophins just in case somehow something had gotten mixed up. As you can see, the uptake on the second scan isn't any better than the first one.
What this really means is that these cells - this whole tract of cells in the reticular activating system has been so badly damaged that the receptors are no longer binding to the neurotrophin. Without that - without the neurotrophin having a viable site to work in the damaged area, treatment just isn't going to work. I'm terribly sorry and I will of course have doctor Hanshaw read the tests as well when he comes in, but I don't think we can help your daughter at all."
Maria turned to Isabel and saw a look of shock and pain. She was pretty sure her face looked just as bad. What had happened was as obvious as it was unexpected. Max had doctored the CD with the results, but he couldn't change the computer info itself. Doctor Worthington trying to be helpful meant that not only was the original test known to be a failure, but there was now a second negative test as well. Maria felt tears running down her own cheeks as tears streaked Izzy's face. In front of them Jeff was comforting Nancy who was sobbing quietly, but tears were trickling down his eyes as well. Sara Worthington was hugging Mrs. P. - trying to console her - and the doctor was blinking back tears herself. It was so ... unexpected .... so horrible. Maria didn't think it could get any worse than this - but she was wrong. Doctor Hanshaw finally showed up.
Doctor Hanshw came through the door and appeared to pay scant attention to the four Roswell people who were tearfully holding one another - or even to Dr. Worthington who appeared to be doing what she could to comfort people and express her sorrow that the tests hadn't gone better. No, Hanshaw merely walked briskly up to the podium and hit a couple keys on the notebook computer that was holding the DVDs with the test images.
"Dr. Worthington told me about the test results but I of course wanted to verify them - just to be sure. Sara is absolutely correct - your daughter's test results are terrible - simply terrible - even worse than I feared they might be when I saw the dreadful damage done here on the initial imaging," Dr Hanshaw said, using a red laser pointer to flicker across the screen in the area of Liz's damaged reticular activating system. "No, I frankly don't see how the girl has even survived this long - perhaps that fading REM sleep she has periodically is somehow keeping these otherwise dead or dying cells active a little longer ... but if she lasts another six months I'll be greatly surprised - a year at maximum."
"Doctor Hanshaw," said Jeff Parker, obviously struggling to hold back his temper, "... this is my daughter we are talking about here. She's not even seventeen years old - her birthday is in just a few days - there's got to be SOMETHING that can be done."
"No - no there isn't Mister Parker. I have studied this for the last thirty years. The damage was extensive enough to begin with, but with the Neurotrophin receptors all damaged so much they can't even bind the neurotrophin - well even her own natural neurotrophins can't be getting through. That means the neurons will die - they are already demyelinating ...," he flicked through the slides, shaking his head slowly, "... no, at this point there's nothing that can be done. It's only a matter of time."
"Can we get some other consultants to look at her?" asked Nancy. "A second opinion?"
"Second opinion?" asked Doctor Hanshaw - apparently rhetorically, "... Why would you want a second opinion? This is the Chicago Neurological Institute - people send patients to us for a second opinion." He shrugged his shoulders before continuing, "... but if you want - sure - grab a phonebook and look up any neurologist in town - I trained most of them. I'll get any one you want to come review the findings on your daughter, but it'll make no difference. They'll all tell you the same thing. No power on Earth could cure your daughter."
"Doctor Hanshaw," Isabel said, preventing what looked to be an angry comment by Jeff, "... I've heard that - well, even if it isn't curative, sometimes - quite often really - the neurotrophins cause at least a short improvement in the patient. Sometimes they wake up for a few minutes - long enough at least for us to tell her how much we care for her - to say goodbye? Could we do that?"
"Out of the question," replied Hanshaw.
"Why not?" asked Jeff Parker.
"Because it's useless. First of all it won't work anyway. That short term rebound works fairly often when the problem is diffuse widespread moderate injury. Your daughters injury is small, but severe, and in a critical pathway. Not the same at all.
"Well could we try?" asked Nancy.
"No," said Doctor Hanshaw, "that would simply be a waste of neurotrophins. You need to resign yourself to reality. Your daughter is gone. You will never hear her speak to you again - she wioll never wake up... and I really am running late. I must go now. Will you finish up here, Sara?"
"Of course, Doctor Hanshaw," she replied, but Hanshaw was out the door before she really got the words out.
Nancy was tearful and Jeff was angry and Dr. Worthington was wringing her hands in obvious distress. Maria and Isabel were holding one another and crying.
"I'm terribly sorry," said Doctor Worthington, "both for the condition of your daughter and for Doctor Hanshaws lack of tact. I truly do wish there was more we could do, and I will of course be glad to arrange a second opinion with any neurologist you would like."
"Thank you Doctor Worthington," said Jeff. "About the neurotrophins though ... We aren't rich - not by any stretch of the imagination - but I'm a small business man. I could mortgage the restaurant ... and we have some savings ... and Lizzy's college fund."
"Doctor Hanshaw is right about that, in your daughter's case it really wouldn't work - not even for a few minutes of consciousness. It isn't even just the money, although the neurotrophins are currently extremely expensive - it's that the supply really is limited, even at that price. Any neurotrophins that were used on patients that we know can't be helped - well, there would be one fewer patient we could help that actually might benefit from treatment. I know Doctor Hanshaw phrased that poorly but the FDA wouldn't let us use the neurotrophins for that purpose anyway - even if they would work. It's an experimental drug. That's a known side-effect, but we aren't approved to give it specifically for that purpose and I honestly don't know what the ethics would be on that either. But we can and will get you that second opinion. Why don't you and your wife come to my office and we'll get out a list of the neurologistys around and you just tell me who you want."
As Doctor Worthington moved off with the Parkers, Maria and Isabel went back to Liz's room. They held her hands and sobbed for awhile. Finally Isabel looked up - wide eyed.
"Oh, no..."
"What is it?"
"One of us has got to go tell Max...."
Re: Informed consent AU M/L ADULT 5/30/2009
Posted: Thu Jun 04, 2009 6:18 pm
by greywolf
- It was 10PM and she heard the door open in the hotel room next to them. She went to the door of their room and opened it, looking out.
“Max, where are you going?” asked Isabel.
“I don’t know – for a walk I guess. I need some time alone Izzy – to think about what to do next.”
Isabel went back in to her own hotel room where Maria hugged her. Both of them had been upset since the morning conference, but Max’s reaction had been even beyond theirs. He had been devastated.
Throughout the day they’d traded out – one staying with Liz and the Jeff and Nancy Parker, while the other one stayed with Max – initially in the coffeehouse across from the medical center, and later back at the hotel. At 8 PM visiting hours had passed, and both girls had dragged Max off to dinner. Nobody had much if an appetite. Max hadn’t ordered much, then picked at it for a half hour – eating almost nothing. They had tried for most of the last two hours to just get him to talk – to let the feelings out – but he’d sat there with moist eyes and a face that seemed chiseled of stone, just staring into the distance. Ten minutes ago he’d gone back to his own room – saying that he was going to bed. Apparently that hadn’t worked.
“What is he going to do?” asked Maria.
Izzy shook her head. “I have no idea. I think that he’s afraid to face Liz in the Abyss – that he’s unable to tell her that there isn’t going to be any treatment.”
“There’s still the hope that the consultant tomorrow…”
“I don’t think that Doctor Worthington is lying to us. Do you…?”asked Izzy, frowning and shaking her head slowly.
“I suppose not? So are you going to go dreamwalk Liz? Are you going to tell her? Do you think she can handle the news?”
“Liz? I doubt that she’ll be too upset, actually. I don’t think she believes any of this alien business is real. She enjoys the company, but I think she believes she’s already gone insane from sensory deprivation in the coma and she is just imagining us. She will miss Max though. If Liz is in the Abyss I’ll keep trying to contact Max in his dream orb – If he’s gotten back by and fallen asleep by then, maybe he’ll still be able to join us."
It was almost midnight and Sara Worthington knew she ought to be home in bed. She’d been up much of the previous night –filling in for the new-father on the coma service and, although she’d gotten a late afternoon nap of almost two hours, she wasn’t as young as she once was. These long hours were starting to get to her. Besides, there was someone warm in that bed – waiting for her return.
But she wasn’t like Doctor Hanshaw. She couldn’t use the armor of cold clinical detachment to insulate her from the pain of the very human tragedy that occurred to her patients and to their loved ones. What’s more, she didn’t want to be like him. That’s why she felt a need to be there with her patients – even if there was nothing she could do to help them - her way of saying that she knew they were still human – still entitled to respect and care. That’s why she had come back to the medical center for yet another half hour after being there fourteen hours already today to have a moment of silence with the latest patient she had been unable to help. This patient hurt more than most – a young woman who had barely started her life and whose condition was no fault of her own. someone only a few years older than her oldest daughter. It all seemed so unfair – but then it always did.
As she entered the room, Sara was at first confused. What was a food service tech doing in this room – and at this hour? At second glance she was struck by the youth of the young man - he couldn't have been out of highschool. When she saw his face she almost turned to get security ... but then the look on the face became apparent - the look of a soul in torment that she'd seen more than once on the face of the friends and family of her patients as a physician on a coma service.
The boy wasn't doing anything but sitting there - holding her hand - tears trickling down his cheeks and fighting back sobs. She looked at the girl in the bed - she'd had good care, but even so, after almost a year in a coma she was certainly only a shadow of her former self - a shadow of the person that this young man had obviously cared for a great deal. Sara took a deep breath, and let it out in a sigh. If she could do nothing for the girl she might at least be able to comfort her friend.
"I'm terribly sorry," said Sara Worthington. "I wish it could have worked out - Maxwell."
He looked up - partly in surprise that she was there at all - partly no doubt that she knew his name."
"Mr. Parker provided me with a copy of the injunction and a mug shot from the Albuquerque police department. I can't say the picture really did you justice though."
"Are you going to call security?"
"No. I think I can trust you, whatever the Albuquerque PD may think, but it is after visiting hours - you can stay a few more minutes - with me here - then you will have to leave - and I'm afraid I'll need the medical center ID as well."
Sara watched as he handed over the badge, his sad eyes going back to the girl in the bed. "So what did the Albuquerque police say and why do you trust me?"
"They thought that you were some sort of a sex fiend - but you don't look like a sex fiend to me."
He shrugged his shoulders, looking back at Liz. "So.... what's a sex fiend look like?"
"Easy," said Sara Worthington, "...my first husband. We met freshman year in college - we were married that summer. I'm amazed I got into medical school - he was sort of distracting - more amazed I didn't flunk out before we got into the clinics - after that I was busy enough that I'd only get home every other night..."
It had been intended as a joke, but Sara realized it had missed the mark when she saw him look back at Liz Parker. "You know, we've never even kissed? Not for real... just in dreams..." He looked up at Sara and blinked back tears. "I think she wanted to ... we were friends - lab partners - I thought we were too different before and now...."
"Remorse. Nothing is quite as awful as an opportunity you chose not to take that you wish you had back..."
"Yeah, something like that."
"I know the medical consultant - the current one, not the crook - for the insurance company. He was impressed by the deal you brokered just getting Liz here."
"All for nothing..."
"You tried - sometimes that's all you can do. I do a lot of it around here - it's the nature of the job. If you care about people, you try, and you obviously care about her."
"Could we try the neurotrophins?"
"Max, it wouldn't work. Sometimes even on unsuccessful cases the treatment will give a brief period of consciousness - an opportunity to at least say goodbye, but with her test results, that wouldn't even work for Liz. The receptors are dead - all the neurotrophins in the world wouldn't wake up those damaged cells."
"What about the stem cells?"
"You HAVE done your homework, haven't you? Her stem cells are probably already maximally stimulated from her own neurotrophins Max, it's just that they can't follow in the tract of the damaged cells. The specific genes that laid down that structure when she was in utero aren't active anymore. Her body doesn't remember how to build a new reticular activating system. I'm afraid that some things we just don't know how to fix, Max, and this is one of them."
The young man looked devastated, and Sara had to fight back the urge to take him in her arms and comfort her, like she would have done one of her own daughters. She watched him turback to the girl - her hand still in his - and saw his shoulders shudder with small sobs.
"Why?" he asked. "Why did this happen?"
"Max, if you are talking religion or philosophy - I don't know. I don't know why any of this happens. Physiologicallly - I can tell you why. Our niche in the evolutionary world is that of sentient being - unfortunately that carries a lot of baggage with it, and one of those is a central nervous system that's very vulnerable to this sort of thing. We have children with the biggest brains that we can get through a pelvis, but at that they are too immature to take care of themselves. It takes the beter part of two decades before they are adults. They spend that time learning with that all-too vulnerable brain - and at any time there can be an accident - an infection - an illness. People think that we are at the top of the evolutionary ladder, but that's nonsense. Evolution isn't about becoming smart, it's about surviving and reproducing. Six billion humans on this planet - that's a pittance, Max, compared to the other creatures. The successful creatures are like the insects - overhalf the species are insects. They are hard to kill - breed fast - mature fast. Being self-aware requires more than that - it requires a complexity that leaves us vulnerable to things like this. Human beings have only been around 200,000 years or so, Max. Life has existed on this planet for 3.8 Billion years. We are a niche species, Max, and a very young one. we were the small mammals who couldn't run fast enough to escape, couldn't fight hard enough to overpower predators - all we have is that brain, Max, big and vulnerable as it is - a brain that tells us how to make tools and how to use language skills. The point is, we aren't really at the top of anything - the very thing that lets us say "I think ergo I am," causes us to be vulnerable to things like this. Just as it's the gazelle's lot in life to be eaten by lions, it's our lot in life to be vulnerable to head injuries. That's probably why we are the only species - out of hundreds of thousands - perhaps millions of species - that use tools and speak - the only one that uses technology."
"So you are saying we aren't really all that advanced?"
"Biologically? No. Despite big brains- maybe because of them, we are primitive - fragile. Someday, if we survive and evolve and don't nuke ourselves into oblivion, perhaps we will be more evolved - still intelligent, but stronger, better able to survive."
"Do you believe in aliens?"
Sara smiled at the quasi non-sequitur
"I don't know. There are billions of stars out there. Maybe there are intelligent beings out there somwehere who went through what we did and have evolved to something stronger - hardier - but there won't be many of them. It's too fragile a niche. But your from Roswell, aren't you? Doesn't everyone in Roswell believe in aliens?"
"I don't think Liz does. I talked to her once about them - she was... she si somewhat of a Miss Scientist. She said she hadn't seen anything to convince her yet. I guess she still hasn't - but if there was only some sort of alien technology that would work...."
Sara looked at the troubled young man. He seemed to be lost in thought - racking his brain.
"Sometimes knowledge isn't the answer, Max. Sometimes you have to just try something and hope it will work. We aren't treating Liz because we have the knowledge to know it won't work.
Emotionally, sometimes ignorance is easier, you can at least know that you are trying to do something. When I was an intern I worked with a resident. We'd get patients with a diagnosis of Guillan-Barre' syndrome. But we had no test for Guillan-Barre, so it was always a diagnosis of exclusion. The Resident would make us go over every square inch of the patient's body, hoping to find a tick."
"A tick"
"There's something called 'tick paralysis.' It looks just like Guillan-Barre' and either one can kill you. We couldn't do too much about Guillan-Barre, many of those patients are just going to die, but if you could find a tick and remove it - and one day Max, one day I found a tick, and that child woke up and went home in twenty-four hours.
Sometimes you just have to change your assumptions - take a chance that you'll get lucky. Sometimes you need to suspendbelief that there isn't hope - even when the conventional wisdom says there isn't. Someday someone may get a wild idea that none of us ever thought of and - voila - But right now, there's nothing more we can do for your friend here. Someday we'll know better - that's why I'm doing research in this - but we aren't there yet, Max. I wish we were, but we are not."
"I know that, Doctor. I know that you'd do anything you can..."
She watched him bend over and give the girl a gentle kiss - could it really be their first kiss? - and after a few more minutes she told him he had to leave. He nodded and walked slowly to the door. He turned, just before he left, and looked back.
"I'm sorry it didn't work out..." he said.
"Didn't work out?"
"Your first marriage."
Sara smiled. "It did. The 'first husband' comment - that's sort of a joke between us. I don't want him to get too cocky. He's home now with our three girls."
"Good," he said, smiling for the first time since she'd seen him. "I like happy endings - I'm glad some people have them anyway."
She didn't say what she was thinking - hoping that he'd one day have a chance for a home and family of his own. Perhaps he'd put Liz Parker behind him and move on - or perhaps there'd be a miracle. He looked like a fine young man - whatever Jeff Parker might think of him. She watched him walk down the hall and minutes later saw him leave the hospital - walking out in the darkness. She said goodnight to Liz, and left for home. She was going to wake her husband - and lose her pain in mindless passionate sex. Too bad, she thought, that Max couldn't do the same.
Re: Informed consent AU M/L ADULT 06/04/2009
Posted: Fri Jun 05, 2009 4:04 pm
by greywolf
- Generally it wouldn't be prudent for a young man from a small town to walk the streets of Chicago alone at 1AM. Most such people aren't street-smart enough to pull it off safely. And it isn't ever safe for someone to walk through the streets of South Chicago where Max walked at 2AM - even the police travel in pairs.
But even the potential muggers took one look at the young man - hesitated - and then backed away. His face was the face of someone who had nothing left to live for - the face of someone who really didn't care if he lived or died - and such people are dangerous even to the predators of the night. In fact, it was probably well that no one did try to accost the young man who walked along in total despair. His life didn't mean very much to him right now - and had someone gotten in his way it was indeed possible that he would have taken some perverse joy out of blasting someone into oblivion. He wasn't looking for a fight - he was looking for hope - but he didn't think he'd find it. As it turned out - he was wrong.
He was lost in thought as he walked through the streets of South Chicago - wandering aimlessly. He didn't notice the drug dealers - didn't notice the prostitutes - didn't even notice the character of the streets changing gradually from tenements to small neighborhoods as he walked along. Although he wandered aimlessly - lost in his own thoughts and despair - somehow he wandered to the university. It was outside the library that he saw the statue in the glow of the lights from the quadrangle.
It was -to say the least - an odd memorial - where once an athletic stadium had stood. The stadium was now several blocks away and the old plot of ground was now part of a library. Where the statue stood had once ben a squash court - and beside it was a brass plaque.
December 2nd, 1942 had been almost four and a half years before a saucer had crashed at Roswell New Mexico. Max had read about the 1940s and the Roswell crash often enough -trying to figure out just who - and what - he was. The allied pilots had called them "foo-fighters' - some believed they were secret technology by the Germans - only to find after the war that the German pilots believed them to be secret allied aircraft. The foo-fighters had largely stopped by the 1950s and by now only a small fraction of the population believed that they had actually been alien spacecraft.
Of course, when your first memory is crawling naked from a pod - and you find you have the ability to manipulate molecules and powerblast and - sometimes at least - to heal, it's a little easier to - like Max - be a believer.
Max and his sister - and later Michael as well - had often discussed who and what they were. Certainly they were 'different' but just what they were or 'for what purpose they'd been put on this Earth' - well, perhaps everyone wondered THAT question, but for the three of them that question had always been more concrete than philosophical. Why? Why were they here? What were they?
For years all of them had avoided getting involved with people - they were 'different' after all. Were they the vanguard of some invasion by 'their' people - the people in the saucers? They hadn't felt aggressive toward the humans - but they hadn't felt part of them either. He and Isabel hadn't even trusted their adoptive parents with their secret. They had kept themselves apart from humans emotionally - or at least tried. But if he wasn't human - why did he ache so much? Why did he feel so much pain about never being able to be a part of Liz's life again? If none of them were human, how could Maria care so much for Michael - or her for him?
Could it be that the three of them weren't all that different after all? That he always could have had parents he could have trusted - that he could have been something more to Liz than merely a friend - not just in her dreams but for real? Could he actually have been her boyfriend - there with her that night when his powers might have saved her from this fate - or at least let him share her fate with her?
And what of his alien gifts? Could they be only that? Gifts FROM the aliens? Could the aliens really be - like Doctor Worthington had suggested - sentient beings in their own lonely niche? Could they have detected the radiation from this first nuclear reactor and somehow known that Earth now had its own sentient life? Could they have seen that life not as a threat - or something to be conquered - but rather as just the emergence of junior members of a very small club.
What if the aliens knew that the universe was a rough lonely place, that intelligence was rare and to be valued? What if they'd abducted people - briefly - to gather their DNA not for any harmful reason - but merely to produce three human beings that had been modified to help humanity survive - survive the centuries until they too would be ready for faster-than-light flight - ready to bend time like the stasis fields of those pods that he was certain he would never understand?
What if this had all been about just sharing with a junior sentient species some of the abilities the aliens had themselves evolved to handle a dangerous and lonely galaxy - the ability to connect with one another - to manipulate molecules - to heal - and the power to protect themselves when confronted with danger? What if these were just survival traits - the Darwinian attributes that had been accumulated by a more mature race of people that were born - like humans - too slow to run and too weak to fight and forced to become intelligent to survive. What if they were truly a gift to the junior species - and he and Izzy and Liz had been meant to be human - to share these genetic gifts with the rst of the human race?
Max knew he couldn't know these things - but he couldn't know otherwise either. Why had he chosen to believe the worst - and deprive himself of any chance he might have had to be a true son to his parents - to deprive himself of any chance to have a life with Liz? Why hadn't he made the other assumptions - the ones that would have at least given him a chance with Liz?
He knew why. He'd imagined the worst to shield himself from disappointment. He'd rejected any chance of real happiness - to avoid the possibility of disappointment. He'd ruled Liz out of bounds - for fear she would reject him. His own fear had brought him to this point in his life.
But if that was the case - if it had been his decisions that had led to this night - then it could still be his decision - his decision to salvage what little hope of joy with Liz that was still left to him.
This night had been an epiphany for Max. He made his mind up - and headed back to the hotel. He needed to sleep and to dream and to hope that Isabel would find him and carry him to the Abyss. He had a lot to make up for - almost a decade of allowing his fears to deprive him of any chance for joy. Sara Worthington was right. Remorse was a terrible thing. But he would salvage what he could of the time he had left with Liz. Besides - miracles sometimes happened. He didn't deserve one perhaps - but Liz certainly did.
It was almost two hours later that Isabel felt the Abyss form as Liz started to dream. She tried Max one last time - scared that he had not yet returned to the hotel - and found to her delight -that he was back. She carried him with her into the Abyss - still frightened about how he would break the news to her - what he would say - how he would react....
Liz looked up as they entered the Abyss - a grateful smile as she saw them materialize. But Isabel's eyes went quickly to her brother - afraid to see him lose it in front of her. But his face wasn't the same as when she'd last seen it - the grief somehow now under control. His face seemed determined - but not as devastated like it once was. Then Isabel watched as he spoke to Liz, wondering just how he would break the news to her.
"Liz," said Max, "...I have something to say to you.."
"Yes, Max?"
"I don't know how to tell you this exactly, so I guess I'll just spit it out. I love you, Liz. I guess I always have.
Will you marry me?"
Re: Informed consent AU M/L ADULT 06/05/2009
Posted: Sat Jun 06, 2009 3:30 pm
by greywolf
- Will you marry me?"
Te words seemed to echo in her mind. Liz knew she was only dreaming - but she hadn't really thought she'd dream of - this. Sure, this was just a fantasy to keep her comatose brain from total insanity - but even so. Max was smiling - his face almost radiating - like she'd never seen him before. But somehow he looked like this was how he should have looked his entire life. It was a happier - more joyful Max that looked back at her.
"Wha -- what did you say?" Liz asked, certain that she really couldn't have heard what she heard.
"I'm sorry, Liz. If we were back in the real world I'd hire a mariachi band - serenade you from beneath your window - toss flowers to you - do my very best to woo you into marrying me - but this abyss is a little bit sparse. All I can do is ask you," he said, getting down on one knee, "... Liz Parker, will you marry me? I mean, I'm sure you could do bettr in the real world, but eligible bacelors here seem to be in short supply. Besides, I love you."
In fact, in all those years of friendship - despite her occasional fantasies - Liz knew she was never going to marry Max Evans. Max - the real Max - for all his friendship - which seemed genuine enough, actually, was always somewhat reserved - someone who would look - but not really participate in life. Someone who always sort of stayed in the background socially - perhaps that was why she had this ridiculous dream about him being alien. No, the REAL Max Evans was Mr. Responsibility - Mr. Loner - Mr. ---- Withdrawn for want of a better world. This dream Max was - spontaneous - a bit of a rogue - his amber eyes somehow smiling at her - not like the sad eyes of the real Max Evans. This Max was asking a not quite seventeen year old girl - if they were telling her the truth about te time since the accident - to marry him. If there was anything more convincing than that that he was only a dream and not the real Max, Liz couldn't think of what it would be.
But perhaps because she really had fallen for Max - unrequited love though she knew it would be - this dream persona of Max - Max the way that Liz believed he could have been - Max the way he SHOULD have been, she told herself, - she found him not just romantic but endearing in a way the REAL Max never was. He was wild and carefree and - Liz decided in a heartbeat - just what she needed to feel alive again.
"Sure Max," she found herself saying. "I'd love to marry you."
Re: Informed consent AU M/L ADULT 06/06/2009
Posted: Sun Jun 07, 2009 1:07 pm
by greywolf
- Maria lay in her bed - watching the clock slowly tick down the minutes until her alarm would ring at 7AM. It had been a long restless night - first trying her best to calm down Izzy about how upset Max was - worried herself about how long he was gone and where he might have wandered off to - but even with his return Maria had not been able to relax. All she could think about was Izzy and Max - in that horrible place - breaking the news to Liz that her last best hope was in all likelihhod now gone. She had no idea how she would have been able to break that news, but she was sure anxious to find out just precisely how those two had.
In fact, for the last three hours Maria had done little but stare at her sleeping roomate Isabel - waiting for some indication of her returning to consciousness. Finally Maria saw some movement under the covers and Isabel's eyes first fluttered - and then opened wide in her own expression of shock and amazement.
"I cannot believe Max said that - or Liz either..."
"Was she just crushed?"
"Liz? Crushed? Why?"
"About not getting the treatment. Max did tell her about that, didn't he?"
"I think it came up as an afterthought, but like I told you - she didn't believe it. I don't even think she believes Max is real - I have no idea why she agreed to marry him."
"MARRY HIM?? What EXACTLY do you mean - marry him?"
"Max.... well, Max proposed to Liz.... and she accepted. They set the date three days from now - the day that Liz turns seventeen. Max says that'll make it easy to remember their anniversary."
"But that's ---What do you mean married? How can they get married? Who is there to marry them?"
Maria watched as Isabel blushed deeply and got a rather pronounced deer-in-the-headlights looks.
"You aren't!! How can you do that?"
"Max said that since the whole abyss was in Liz's mind, she was the supreme authority there. If she wanted to delegate me power to perform the nuptials, she ought to be able to. Then she asked me and - how could I turn her down? How could I turn Max down when he obviously wanted to be married to for however long she has left. If that's only six or twelve months - I mean what can it hurt? It's all in Liz's mind anyway and already I have to wander out into the mist when they get a little too amorous already - I guess I can wander a little farther - although I can't quite see my shy brother having any sort of honeymoon with me listening fifteen feet away..."
"Isabel - you have got to be kidding me... Open the door - I've got to see what Max says about this."
Isabel shrugged her shoulders and used her powers to open the door to the adjoining room. Maria walked in and found Max awake - still wearing the rumpled clothes he'd worn the day before - sitting at the desk and copying what appeared to be a wedding service from an online website.
"Omigawd - I'd thought Isabel was pulling my leg but....," she left the room shaking her head, closing the door behind her. Isabel looked up as she stumbled to a chair.
"You would have had to been there, Maria. I've never really seen Max like that. Max was suave - debonair - gallant. This from a guy who has always been a total social misfit. I never saw him like that before - not in his whole life. I could hardly blame Liz for accepting."
"But...," Maria started to say. It seemed unfair ti Liz somehow to allow her to go through with this - not even understanding that Max was real and really was alien and that this marriage was real to him..., but then she thought of Michael.
She had, she realized, fallen in love with Michael. Now that she knew the truth, she couldn't say she loved him any less because he was what he was. Max had at least tried to explain the truth to Liz in the dream-orb - although in fairness, she guessed Michael had as well, the only way he could. It couldn't have been easy for any of the three of them - deprived of a real childhood and growing up knowing they were different and frightened to death that the world would find out. All three had, in their own different ways, pushed the world away because they never really believed they could be accepted. Even that night in the rainstorm - Michael had seen her in the warmth of her bedroom and never believed she would open the window for him - much less her bed.
No, she loved her Spaceboy and no doubt Liz loved Max, even if neither of them really understood what was going on as they fell in love. She would have to work out her problems with Michael. Liz - well, Liz had six months to a year left, if Doctor Hanshaw was correct. Let Liz and Max find as much happiness as they could in what little time the girl had left.
"But...what?" Isabel asked.
Maria put on her best smile. "But nothing .... Give Liz my best. Tell her I wish I could be there with her to be by her side on her big day like we promised in sixth grade. Tell her I hope they have a great life together." 'At least, they'll have each other' she thought, 'for as long as it lasts....'
Maria and Isabel got ready quickly. They needed to be at the Medical Center in only an hour. The last-chance consultant was probably already there, examining Liz's records - coming up with his second opinion. They wanted to be there for the Parkers when the final verdict was in.
Re: Informed consent AU M/L ADULT 06/07/2009
Posted: Tue Jun 09, 2009 7:23 am
by greywolf
- It was 1PM at Chicago O'Hare airport and Southwest Flight 229 to Albuquerque New Mexico was in the final stages of boarding. The flight had been fully booked, but the Boeing 737 carried 137 passengers, and it was only normal that one or two would miss their connections or otherwise just not show up on time. There were no assigned seats, and when the last head count by the senior flight attendanty had been taken, there were still three seats unfilled.
"Last call for boarding Southwest flight 229 to Albuquerque....?" the gate agent said hopefully, but a look down the long corridor showed no one heading toward gate C32. With a sigh and a shrug of her shoulders, she keyed the PA mike again. "Will standby passengers Evans and Blakely please come to the counter?"
Max had gotten the call from Izzy and Maria only an hour ago. But a single guy with only a carry-on could move pretty fast - certainly faster than a comatose patient could be moved. Fifteen minutes later the flight and Max were winging their way southwest. He'd be in Albuquerque in a few hours - back in Roswell four or five hours after that. With luck he'd be home before Liz's jet even got airborne and that would be fortunate. Max had a lot of preparations to make.
Representatives from the insurance company - which was based in Chicago - met them at the airport as they loaded Liz into the air ambulance. They expressed their regrets that the treatment hadn't worked - they even sounded sincere. They told Jeff they would continue to cover Liz's treatment at the rehab hospital for a couple of days to give im time to find a good hursing home for her. Maria and Isabel both volunteered to go see her every day - to do the physical therapy on her she was now getting from licensed physical therapists. They knew it wouldn't be as good but it was all they could think to do. Jeff thanked them for the offer - it was certainly better than nothing - which was precisely what Liz would otherwise be getting.
It was a pretty dispirited traveling party that boarded the air ambulance aircraft with Liz Parker at 8PM. Nancy wasn't talking much - just looking devstated with tears occaisonally tricking down her cheeks. Jeff Parker was sitting there stunned. Despite what Dr. Worthington and Hanshaw had said the day before, he'd still thought the independent consultant would at least give them a little hope. He'd been more considerate - more humane - but his actual assessment actually didn't differ from that of Hanshaw. 'Six months to a year...,' he'd said.
Jeff Parker looked back at his daughter - her skin pale and her body somewhat wasted by mscle atrophy, despite three hours of physical therapy a day. What Jeff saw though wasn't just what Liz was now - he saw a little girl whose father had just taken the training wheels off her bike - wanting him to let go and let her ride like a big kid - even though she skinned her knee doing it. He saw his daughter the honor student - getting her certificate at an awards assembly - he saw the dream he had started havig ever since he saw what a beautiful young lady she was becoming - the dream of walking her down the aisle, her face lit with a smile.... a dream he now realized he would never see come true.
He looked at Nancy and told himself not to cry - that would be the final straw that would push his wife over the edge. Finally, 30 minutes out from Roswell, he excused himself and headed for the restroom. In the silence of the restroom he cried like a baby for five minutes - finally washing his face and drying his eyes, before going back to his seat beside Nancy.
It was dark when the plane landed. Michael watched Maria's sad face as Liz was loaded in to the ambulance. He wanted to hold her - comfort her - tell her that he'd always be there for her. But he couldn't of course. He wished that he could have found some way to be honest with her - wished that he could have set aside his fears and just told her the truth before he'd ever gotten involved this deeply. He walked up to her and gave her a hug.
"I missed you," he said not daring to say what he really meant - that he loved her.
"I missed you, too," she replied, still not willing to be the first to say the "L" word. "Can we give Izzy a ride to her house?"
"Sure," Michael replied. He'd borrowed the Jetta from Mrs. DeLuca - his bike was back at Maria's house. They rode in silence to the Evans house where Izzy hugged Maria and got out, a look of irritation on her face as she told Michael good-night.
When they got to the DeLuca residence, Maria went inside and told her mother she was home. Then went out to tell Michael good-bye. Michael had seen the look on Isabel's face - obviously she didn't approve of how close his relationship was to Maria. No doubt she'd have been really pissed if she'd realized how close it had become. But he didn't care - sacred vow or not - Maria was more important to him - more important than anything or anyone in this whole world.
"Good-night, Michael," she said, giving him a soft kiss and handing him his helmet.
"Good-night, Maria. Uh, Maria..." he said, taking off his helmet and letting it fall to the ground as he took her hand...
"I love you, Maria..."
His heart leaped with joy as he saw her smile for the first time that night. She kissed him again softly, before turning around to go back in to the house. Then she hesitated, a twinkle in her eye visible even in the moonlight. "I love you too, Spaceboy..."