March 24

So I just got back from a weekend with adam and have some more detail for everyone, pardon me if I ramble....

Its a pretty somber scene at kings county hospital. Adam has now been in the intensive care unit for 1 full week. When he was brought in last sunday, doctors didn't think he would survive. That has changed. That is the good news. The bad news (and I am not going to sugar coat anything) is that he is still critical, and isn't making any great progress. We have to view every little baby step in the right direction as a step in the right direction. Of the two days Amie, Gareth, and I spent at his bed side nothing really changed. The doctors won't give the family any idea as to how long he will be in the ICU, let alone how long he will be in the hospital. They are telling him that full recovery (if we can expect such a thing) will more than likely be a year or two. Now, we all want to get him back to California ASAP, but again, we have no idea how long that will be. Best case weeks.

The doctors are telling jeff and diane they want to make some changes to his set up. He has tubes and sensors all over his body. He has a feeding tube and breathing tubes jammed into his mouth down his esophogus that are very agitating to him. He has a cathater and a thermometer in his rectum, he has multiple IVs, and 10-15 vitals being monitored by sensors all over his body. He is completely incoherent and was the entire time we were there. The doctors and nurses cycle him on and off of sedatives every few hours to see if he will respond to any commands. This is painful to watch, not just because he still isn't responding, but because it looks like he is being tortured when they try to wake him up, he gags on the tubes, arches his back, coughs up fluid, kicks his legs wildly, pulls his hands up and down (though they are tied to the bed to avoid him from pulling his tubes out or knocking off his sensors or IVs.

Possible negligence on the part of the hospital: adam's hands were not initially tied down when he was unconcious and the tubes were placed in him last sunday. He had a moment of conciousness and pulled out his tubes, asberated (spelling) and contracted pnemonia. This is a problem because now they have to keep him on the breathing tube and resperator, which is problematic because that is the biggest annoyance to him when they try to bring him back to conciousness. THe pnemonia was getting progressively worse until THursday of last week when it stabalized. We are hoping that will get under contral ASAP so we can get on with the nueological testing.

When I say responding and not responding let me explain. he is responding to people pinching him under his arms (he kicks his legs and acts annoyed) and he responds to people rushing a hand to his face (he blinks). Other than that he is completely incoherent, he opens and closes his eyes, but no one is home. Totally glassy.

The doctors test for respones to commands so they ask him for a thumbs up, or to squeeze there hand, but he hasn't responeded to any of this yet. As he is coming off the sedatives they yell these commands at him until he starts coughing and gagging on the tubes in his mouth and throat, kicking and thrashing, but not responding, then they dope him up again. Over and over. All day long. It is really terrible to see. I question why they do it this way, can't they just accept that his brain is in the state its going to be in until they can get these tubes out of him, just hold off until the pnemonia clears, get him off the respirator, then do the nerulogical tests. I have to assume they know what they are doing.

Two of the tiny baby steps that we have to view as improvements to keep positive were on saturday they took out the cranial pressure tube because his pressure had stabalized to the point where the risk of brain infection was greater, so they pulled it. On sunday they decided to move forward with a traciatome (spelling?) and plug the feeding tube into his stomach directly. It sounds like these steps will be setting him up for the longer term in the ICU, where as the tubes were a quick fix. Another sign he will be there for a while.

In regards to setting up for the long term, all of us need to do that emotionally and not set high expectations. His family had at first, and every day got harder as the lack of significant progress as you can imagine when all you are doing is watching him 20 hours a day could be frustrating. Also there are some real logistical challenges for the family. The hospital is in the ghetto. Let me be clear on that. I have been to highland hospital in oakland, and this hospital and this area is FAR worse. I have to wonder what adam was thinking walking home alone! We wouldn't go anywhere without John who was armed. Where adam was beat up was a couple miles from there, deeper still in the projects.

His friends in NYC have been wonderful. He has made a great many of them in such a short time his family was really suprised at their support. Joan, Nam and Angela have been really great coming to the hospital often, Joan lending the family a car. The rabbi keeps an apartment for people in the pates situation and has let them stay there. Its a dingy one bedroom, but a shitty hotel in brooklyn is $180 a night and if they are there weeks if not months, this can really add up.

So, thats my ramble for this morning. I think being out there really helped boost the families moral and adam's if he could here us. I didn't have a chance to play the messages for him as the ICU was so lad the spearkers couldn't over power the respirator and things. No headphones allowed yet. But I know that will be really great for adam when he comes to.

Thanks to everyone for their support. I'm going to try to fly back out again on friday night. If anyone wants to come from california let me know. I think the family can use all the support they can get. Diane has taken a six month leave of absense, and John is going to be out there for at least a month. Lets hope he is back before home before then.

Mike