32 - August 1, 1977

In the weeks following her admission to the Intensive-Care Unit at Cincinnati Mercy, Erica Johnson’s most ardent fight with Sickle Cell had reached its peak. The crescent-shaped red blood cells had congregated and blocked the blood flow within part of her brain.

A giant pool of stagnant blood had clotted and clogged part of the right side of the brain, shutting down a slew of vital processes.

The first visible sign was her twitching left eyelid. Then, she felt the tremors all across the left side of her face. Her left cheek sparkled with electric sleepiness. Her lips were like liquefied earthworms struggling for air after a fresh spring rain. Her left nostril felt fat and fleshy. Even the top of her head was partially numb. When she rubbed her hand across her scalp, it tingled, no different than a limb anyone could experience after a long, awkward sleep.

Half-words and broken phrases tumbled out of her mouth as she begged her mother for help. Mrs. Johnson recognized the signs immediately. She’d seen Robert go into convulsions and talk in half-sentences several times before. In fact, she’d become hardened like a battle-tested nurse, able to react quickly and act efficiently to come to her husband’s aid.

When Erica stumbled over her words, however, Mrs. Johnson stumbled through her own thought processes. The shock of hearing her little girl’s dysfunctional speech elicited the worst possible reaction in Victoria Johnson. She completely froze.

Robert, however, was nearby. So, too, was Byron, and in an instant, both of them sprang into action. Mr. Johnson tended to Erica while Byron called the fire department.

“I felt totally worthless,” Victoria confessed to her husband.

“You did just fine.”

“I didn’t do anything. I just stood there. I could’ve killed her.”

“Under the circumstances, your reaction was perfectly normal. I don’t think anything more could have been expected.”

Those words were of little comfort to Mrs. Johnson. After all, Erica was her only daughter and youngest child. She had taken all the classes with her husband and read all the first aid manuals. In all reality, she scoured them, keeping the guides in her bedside table for late night reading material.

Reading and rereading those little first aid manuals, however, seemed useless.

“I let her down,” said Victoria.

“For once and for all, Victoria, you did no such thing. You’re only human.”

The first week in the hospital, we all took turns staying with Erica. I held her hand tightly whenever I was there, day or night. Her condition fluctuated as her body rejected the latest round of blood transfusions.

“Oh, here he comes again,” she moaned.

“Who?”

“The King Crab of Death.”

“The what?”

She grasped her chest as she attempted to breathe. Her face contorted in pain.

“It’s like a giant crab grabbing onto my chest and crushing my rib cage.”

“Should I call a nurse?”

Erica hyperventilated as she nodded to me.

I ran into the hallway and frantically looked both ways.

“Nurse, please come here quickly! We need your help!”

The nurse sprinted toward the room and looked Erica over. She simultaneously picked up the phone and punched the call button. A battalion of nurses and doctors quickly came to Erica’s rescue. Then, they went to work on Erica as the nurse shooed me away.

She leaned over Erica as she administered chest compressions. Then, I watched as people rushed into the room. The attending physician checked Erica’s airway.

“Are we getting any respiration?”

The nurse shook her head.

“Hold on a second while I insert an airway.”

He tipped Erica’s head back and carefully intubated her. Then, he connected a Foley bag and squeezed gently, forcing air into Erica’s lungs. Another nurse entered the room and started checking vital signs. An orderly pushed me aside as Erica’s caregivers carted her to the elevator.

“Where are you going?” I asked.

“The cardiology unit,” said the orderly, “she’s going into cardiac arrest.”

Erica, in her gurney, and a group of four loaded into the elevator and then disappeared as the doors closed. I stood alone in the hallway for only a moment, stuck in a sort of limbo. As soon as I snapped out of it, I headed downstairs to the waiting room. I found a payphone and dropped a pair of dimes into the slot. Without thinking, I automatically dialed the Johnson’s phone number.

“Hello?” said Mrs. Johnson.

“Hi, Mrs. Johnson, it’s me, Jacob Jolley.”

“Yes, Jake. What’s wrong?”

It wasn’t an unusual question, especially considering the recent string of events and it shouldn’t have taken me by surprise at all. Still, I replied as a matter of fact. Erica was sick. 

“Erica just went into surgery.”

A vacuum rush of air swept up from the mouthpiece as Mrs. Johnson gasped in shock.

“Mrs. Johnson? Are you okay?”

“Yes, yes dear, I’m fine. We’ll all be there as soon as possible.”

I stayed near the payphone, manning it like a switchboard operator, making calls to every number that came to mind. When I finished scanning the personal Rolodex in my mind, I scanned the phone book.

“How many people did you call?” asked Byron.

“I’m not sure, maybe twenty, maybe more.”

“That’s so insensitive and thoughtless.”

“Huh?”

“This is a private family matter.”

Byron stormed off in a huff, leaving me alone at the payphone again. When I told Fitzie what happened, he agreed with Byron. It wasn’t the opinion I expected or wanted. When I turned to my father, he offered his own bit of personal insight.

“Look Jake, not all people are like you. They don’t wear their hearts on their sleeves. Whether it’s Mr. Johnson or Byron, they usually keep a good part of their private lives private. The reason you don’t see that is because you’re part of their inner circle.”

“Oh.”

“Well, what’s done is done. Just be there for Byron and like all wounds, it’ll heal, given enough time.”

I sat in the waiting room with my friends and family, keeping clear of Byron. For the next few days, we didn’t even speak to each other.

“She’s back in the ICU,” said my mother, “do you want to go visit with her?”

“I don’t know,” I sighed.

“Come on, it’ll be good for you. Plus, I’m sure she wants to see you, too.”

I rode up on the elevator with my mother. I was hardly thinking about Erica at all; my head was occupied with thoughts of what I’d say when I saw Byron. As we headed down the hall, we ran into Mr. Johnson, who was reclining uncomfortably on a hard plastic chair just outside Erica’s room.

“How’s she doing?”

“She’s hanging in there, but the doctors say the blood transfusions aren’t taking, so there’s still quite a long way to go.”

In an attempt to comfort Mr. Johnson, my mother patted him briskly on the back. It felt forced, like she wasn’t sure how to act – other than fill in the blank space between words. He gave her a reassuring smile before returning to his chair. We headed into Erica’s room.

Byron sat with Mrs. Johnson on the opposite side of the room. As we entered, Byron glanced up from his copy of Sports Illustrated, but only momentarily. Mrs. Johnson, however, not only acknowledged our presence, but moved to greet us.

“Oh, it’s so good to see you guys.”

“It’s good to see you, too, Victoria. How’s Erica holding up?”

“She’s doing better.”

I stood beside the bed, pondering over Erica. A slew of tubes trailed from her arms and belly. An oxygen mask delivered a slow, steady supply of oxygen as she slept. I stood there momentarily, listening to Erica’s breath keeping a steady rhythm as the bellows moved up and down. Finally, she emerged from sleep.

“Hey,” she said with a slight gasp.

“Hey.”

She pulled the oxygen mask from her face and rested it upon her forehead. She squinted as her pupils narrowed in the bright fluorescent light. Her lips were ashy and gray. I reached out my right hand and hooked my pinky with hers. A faint smile lit up her face.

“It’s so good to see you,” she said.

I nodded. She turned her attention towards my mother, who was standing on the opposite side of the bed from me.

“It’s good to see you too, Mrs. Jolley.”

She leaned up towards my mother and my mother bent down and embraced her tightly. Erica exhaled deeply as she hacked and coughed. My mother immediately eased Erica onto the mattress.

“Oh dear, I’m so sorry.”

Erica waved her off casually, as if to tell her not to worry. Still the coughing and hacking continued as Mrs. Johnson came over and placed the mask on Erica’s face. Erica inhaled deeply. A fresh supply of pure oxygen raced through Erica’s bronchial tubes, relaxing the muscles in her chest. Those little sickle-shaped cells seemed to breathe easy, too, as Erica’s eyelids fell slightly.

“She needs her rest. Maybe we should clear out and give her some time to herself.”

My mother nodded in agreement, so we said goodbye to Erica – at least for now – and the five of us (including Mr. Johnson) headed to the elevator. I remained silent as I stared directly at the floor indicator over the doors. It rang out the floors as it counted backwards from six to L. Then, we quietly disembarked.

The adults sat in their normal groupings: men with men and women with women. I sat to one side of Fitzie and Byron chose the other.

“How’s she doin’?”

“She’s just a little tired,” said Byron.

“That’s good, right?”

“Yeah, I guess so, but I’ve never seen her as weak as this.”

I remained silent on the matter, but Erica’s spirits did seem unusually low. It was as if she’d already given up the fight. The battle inside her body continued though, as her diseases continued to devastate an already failing system.

“Erica?” said the nurse, “how are you feeling today?”

“Okay, I guess.”

“You’re holding up really well, considering all things. Just keep positive and we’ll get through it, one day at a time.”

Another set of blood work and x-rays came back on the last day of July. Mr. and Mrs. Johnson met with the doctor in his office to discuss the results.

“Well, Mr. and Mrs. Johnson, as we look at her numbers, there are a few areas for concern. First of all, her white count is extremely high. That means her body is fighting off some disease. That looks to be a simple chest cold, but given her pre-existing Sickle Cell, no cold is ever simple. On top of that, her lipids are high, and cholesterol’s clogging her arteries.”

Mrs. Johnson shifted uncomfortably in her seat.

“I wish that was the worst of it.”

The doctor turned on the light box and turned off the overhead lights. X-ray images of Erica’s brain delivered the horrifying news in black and white.

“Do you see this black portion? That’s the original blood clot. There’s an extra mass we’re worried about, it’s the lighter gray area beneath the clot. It could be something as extreme as a hemorrhage or a tumor. Either way, we have to go in and investigate. Even if it’s just a blood clot, that’s where the brain is no longer getting blood, which means it’s malnourished. If we don’t operate, these parts of the brain will die and she’ll lose those functions forever.”

Mrs. Johnson remained silent and Mr. Johnson nodded agreeably. The doctor gave them time to visit with Erica.

“Hello, dear,” said Mr. Johnson as he bent over and planted a kiss firmly on his daughter’s forehead. Erica smiled.

Mrs. Johnson pulled her lips between her teeth and pressed down firmly. Her jaw quivered the slightest bit as she tried to speak.

“Mom, what is it?”

Mrs. Johnson drew a deep breath as she tried to speak. She raised her hand to her face and firmly pressed her fingers against her quivering mouth.

“Victoria, wait outside,” said Mr. Johnson.

Mrs. Johnson pulled the door closed as she left. Erica’s eyes grew wide with anticipation.

“Dear, we spoke with the doctor this afternoon and he says you’ll be headed into surgery tonight.”

“I know.”

“What did the doctor tell you?”

“He told me my chances aren’t the best.”

Mr. Johnson nodded. His little girl was handling it flawlessly. He reached out and held her hand in his. Then, he clamped the second hand on top of her outstretched hand, creating a tiny sandwich. Her tiny fingers were chilly, but they warmed slightly under his warm and gentle touch.

“Who do you want me to send in next?”

“Send Jake…and my brother.”

“You want me to send both of them…at the same time?”

Erica nodded.

Mr. Johnson gave his daughter a slight sideways glance. Then, he gave her a wink and a nod as he smiled at her. He knew, if anyone could fix the two of us, it was Erica.

“Byron, Jake,” he called, “Erica wants to see the two of you.”

We stared each other down for a moment as Mr. Johnson motioned for us to get off our seats.

“Why does she want see both of us?” asked Byron.

“Beats me, why don’t you find out for yourselves?”

We headed to the elevator together – or as together as we had to be. We still remained silent the whole way up to the sixth floor – and down the hall, too.

Erica shifted in place as the two of us entered her room. Byron went to the far side of the room, which placed the bed (and Erica) between us. She frowned at both of us, one then the other.

“What is wrong with you two?”

She motioned for me to move around the bed and stand next to her brother, so I did. We stood awkwardly beside each other, unable to make eye contact with her.

“Byron, he was just trying to help.”

“But your disease isn’t anyone’s business.”

“He did it because he was concerned.”

Byron folded his arms.

“Apologize to him.”

“I’m sorry, Jake. I know you were just trying to help.”

“No problem.”

“Now is everything all better?” said Erica.

We both nodded.

“Good, now hug.”

We both glared at Erica as she kept a straight face. Then, a smirk sneaked out of the corner of her mouth, followed by a whole-hearted laugh. She took a deep breath through her oxygen mask and moved it onto her forehead and smiled. She followed a light, raspy cough with her one-of-a-kind smile.

“The doctor told me I had to keep positive and seeing the two of you fight wasn’t helping me one bit. Now, I’m good to go.”

We each hugged her tightly and wished her well before she went into surgery. After that, we returned to the lobby and waited.

The first hour was long and arduous as we sat in the waiting room and waited. The television always seemed to be tuned into a channel none of us would normally watch. Of course, that also meant it wasn’t WLWC, which also meant we didn’t get to watch the Reds game.. That, of course, had been the way of things ever since we arrived at Cincinnati Mercy.

The second hour was shorter than the first. The third was shorter than the second, and so on and so on. Meanwhile, it probably dragged on for the surgical team attending to Erica.

They began with anesthesia. It was a delicate operation, due to the fact they would be carving directly into her cerebral cortex. The sub-dermal mass had to be kept alive and working, or else they’d risk further damage.

They gave a light dose of general anesthetic to keep Erica just below the level of consciousness.

The nurse used a pair of scissors to chop the hair short. Then, she took an electric shaver to create a bald patch for the field of surgery as the general anesthetic took hold. The remaining anesthesia was administered in two phases: the nurse massaged jelly into the bald patch and after the injection site was numb, the surgeon injected a needle into artery just ahead of the clotted matter.

By the time Erica arrived in the operating theater, the surgical team grew to about ten.

The chief neurosurgeon created an incision in the skin where he’d operate. He peeled away a flap of skin to reveal the sub-derma and skull. The nurse applied suction and liquid to keep the target area as clean as possible. Then, the surgeon drilled a small pilot hole in the skull. That was followed by additional drillings, creating a two-inch entry point for the scalpel. Light suction carefully pulled blood away from the soft brain matter beneath the clotted artery. Then, the surgeon used a sharp probe to clear the clot from the artery. It turned from purple-black to light red as clots of blood were siphoned away by the blood pumping through Erica’s brain.

Another surgeon reached in with a spoon-bladed scalpel and pushed the artery aside. The chief surgeon nipped at the hemorrhage while another surgeon used suction to remove the gelatinous red hemorrhage. As they neared completion, they changed from suction to forceps and a water stream, to avoid damage to the fragile brain tissue.

When they finished, the surgeons patched their work with bone, skin grafts, and a form of Super Glue. It was at least ten hours until the surgeon came out to see us.

“How is she?” asked Mr. Johnson.

“She’ll be fine. She just needs to take it easy for the next couple of weeks. You know what they say, ‘slow and steady wins the race.’”

It wasn’t, of course, a matter of weeks, but the way Erica would go about her daily routine for the rest of her life – the specter of death would always loom over Erica and her family, even if it took its own sweet time getting there.

We spent our days after that surgery much like the days we’d spent before, although Erica would never again play Wiffle Ball with us, let alone softball or even go biking to Kennedy Park with the boys.

She did, however, sit in the bleachers, keeping score and cheering for us. Whenever someone hit a foul ball, a team of friends made sure Erica was out of harm’s way. Sure, it was a little over-protective, but Erica loved the extra attention. Still, she found a way of making lemons into lemonade.

In the meantime, the rest of us just breathed deep and stepped light.

.