When the caller ID shows Unavailable on the house phone, I don't think too much of it. But when Unavailable calls my cell phone thirty seconds later I would be a fool not to answer. Unavailable turned out to be a nurse named Heather calling me from a hospital in Florida and asking me if I knew a Jonathan who's last name happens to be my maiden name.

For the third time in the past 2 years, I felt my blood turn to ice again.

They told me that my brother was there in the ER and that he was alive but that they couldn't tell me more. They were trying to reach my parents who at the time were cruising the Caribbean. For some reason I couldn't recall what cruise line they were on but I took down phone numbers and names she gave me and promised to call back as soon as I could get through to them.

I'll keep the details spare but I assure you that it was very difficult successfully connecting with them on the ship at sea and coordinating things that needed to be done to get to Florida. In between making these arrangements I was on and off of the phone with the nurse in the ER trying to figure out what happened.

The HIPAA laws are a great thing in most respects but sometimes they frustrate family members and health care professionals alike. If you're lucky and perhaps say the right things, you can derive a little bit of information which might not relieve you but will at least give you an idea of what you are working with. And what you should be praying for.

I could ascertain that my brother was alive, that this event was not the result of a motor vehicle accident, but that he was extremely sick. Crying and pleading with the nurse, plus promising to never sue, I was able to get her to obtain verbal consent from my brother to give me certain details of his situation. She was able to tell me, through very specific questions I asked, that he had no apparent head trauma, that his level of consciousness was low but that he was able to speak a little, and did not appear to be in pain.

I asked about his toxicology to which she replied, "I do not have permission to discuss that."

So, we know where this is going. We know that my worst fears regarding him were true. And we know that with all of the diagnostic data that I obtained, that he was truly on the cusp of life and death at the moment.

The human body is a beautiful organism. Under favorable circumstances it functions better than a well oiled machine. The flux of sodium and potassium through cells, the lightening speed bolts of neurotransmitters across synapses, the dance of chemistry and electricity that makes our hearts beat in perfect rhythm, and every other minute function of our body that sways through us in good healthy was deeply compromised in my brother's body.

My brother's potassium had climbed to an 8 (normal is 3.5 to 5) and that his ECG showed peaked T waves due to hyperkalemia (increased blood potassium level). They were doing what they could to decrease the potassium but this is very dangerous territory. I knew that my brother was very close to a lethal cardiac event and just wanted to talk to him, to possibly infuse him with calm and prayers and love in case he wouldn't make it.

When I spoke to him on the nurse's phone I just telling him that I felt nothing but love for him and to calm down and to be receptive to whatever the people in the ER needed to do with him. I put blind faith into the notion that they were well-qualified to deal with him properly and that life would deal us a better hand in the next few minutes. Groggily he told me he loved me and the conversation was over.

A subsequent phone call revealed that my brother was in rhabdomyolysis. My brother's kidneys were not functioning. Kidneys constantly filter our blood, assessing the basic chemistry of our bodies and by way or osmosis and active transport ensure that we have the proper amount of fluids and chemicals circulating through our bodies at any given time. From nursing school until now I have considered kidneys to be the complementary set of chemists our body houses to keep us alive and well.

By that time my inlaws had picked up Penny to spare her my explosion of mental anguish and to allow me to coordinate contacting my parents, organizing Sadie and her care of the dogs, and obtaining plane tickets down to Florida for myself and my boyfriend Jordan. During this time managed to establish contact with my parents and discussed my brother's condition with the ER.

Jordan was a rock and his parents were beyond helpful with obtaining tickets for us. I felt helpless and yet I felt completely supported by the goodness of others around me. Again. I can only sum up my feelings regarding the goodness of people by quoting Carl Rogers who said, "when I look at the world I am pessimistic, but when I look at people I am optimistic."

Later that night, when arrangements had been made and there were no more phone calls to make I sat and worried and prayed and somewhat distracted myself by watching the Yankees earn their way to World Series. The magical, schizoid part of my brain again related the victory of a sporting event with a fortunate personal outcome.

The next afternoon I was back in Florida, at his bedside in the ICU, and told him simply "I came here to tell you the Yankees won last night."

***

My brother wound up admitting to me that he had done some cocaine, possibly laced. Cocaine alone can land you in this state because of it's very effects on the cardiac system. It can tax your blood vessels all the way down to a microscopic level, and the kidneys have tons of activity going on at the cellular level. Use of cocaine is heavily associated with rhabdomyolysis.

I cannot even address this aspect right now. It was the direct result of hard drug use. There will be more words on this in the future, trust me.

***

Tonight I sit at my computer in New Jersey. The days have passed by with much improvement, propelling my brother away from a lethal condition and into a future that seems filled with hope if he can keep himself away from what landed him in the hospital in the first place. He's had 4 or 5 dialysis treatments and while his body chemistry needs vigilant assessment and treatment, he is a live and will mostly likely remain so.

My brother's kidneys may or may not function independently in the future. Tonight they do not, but the toxins have been cleared of his system, at least temporarily, and he is lucid. This may be the break they need from the onslaught of substances they ordinarily take in, assess, and discard into urine. Or they might need a longer period of rest. Or they might not ever wake up.


Regardless, he is alive.


*****
I have found myself being strong through this situation. I think the road I have traveled since Rob died has made me a stronger person. I honestly think that is the case. I had a therapy session on Thursday (what timing!) that reaffirmed my suspicion that I was handling everything appropriately. My mind was definitely playing tricks with me afterwards, especially at night with my funny little of habit of not sleeping during times of stress and all the weird little acrobatics and cartwheels my mind can perform under these circumstances

I do not know what the future holds but I know that he is alive and we can work with that.

Love,

Liz