Chapter 11 - The Big One (Cont.)

Through the interpretation of the nephew, Neil tried to explain the situation to Foua. He thought when he finished explaining about the transfer that they understood the reason why and agreed. However, they had an entirely different understanding of what he said. “The Lees believed their daughter was transferred, not because of her critical condition, but because of Neil’s vacation plans, and that if she had stayed at MCMC, he would have restored her to health, just as he had on every other occasion. As for Neil, he felt terrifically sad, because he didn’t know what Lia was going to be like when she came out of this. He was pretty sure she wasn’t going to be the same.

During the seventy minute drive to Fresno, Lia got worse. When she arrived, she was in the throes of another grand mal seizure. It’s hard to imagine a more difficult or unpleasant case than Lia’s must have been during her admission. A huge team of doctors was necessary for her care, and they worked so hard to save her that the lead doctor didn’t even notice that she was a girl, referring to her as “he.” This is American medicine at its best and worst. The doctors was able to disregard her as an individual in order to concentrate on saving her life, but she no longer was Lia Lee, just a body which was dying. As soon as Dr. Kopacz saw her, he diagnosed her condition as “profound shock, probably of septic origin.” This meant that the septic bacteria had invaded her bloodstream, and her organs were now shutting down. The mortality rate for this kind of bacteria is between forty and sixty percent. In Lia, everything was going wrong at once. She was loaded down with medicines and tubes were going in and out of her everywhere. She was being given every known test and every medical instrument that could help her was being utilized.

However, at 11:00AM on Thanksgiving Day, Lia crashed. The ability of her blood to clot had gone haywire. The doctors stopped this crisis with a double volume exchange blood transfusion. It finally worked. Then, they gave her a spinal tap to find out if the sepsis had passed from her blood to her central nervous system. But this really distressed Nao Kao, because he believed that by sucking her backbone like that they had lost Lia. Lia also went through a number of diagnostic tests like an abdominal ultrasound and a Gallium scan which introduces radioactive tracing material into the bloodstream to identify the infection.

In the meantime, her parents lived in the waiting room, sleeping in chairs for nine consecutive nights. They were only allowed one ten-minute visit every hour. They had no money to pay for a motel or food. Their relatives brought them rice once a day and that was the only food they had. They remained baffled by what was happening and when the doctors explained that they needed to perform two more invasive tests, the Lees had no idea what these procedures were and thought they were giving Lia “sleeping shots.”

The same day, Lia was sent for a CT scan and an EEG to see how her brain had weathered its prolonged oxygen deprivation. She had no gag reflex, no corneal reflexes, and no response to deep pain stimulations. It couldn’t have been a more tragic diagnosis: Lia was effectively brain-dead. Then, Jeanine Hilt was called and told the doctors were preparing the family for Lia to die. The doctors wouldn’t even look at Foua and Nao Kao, but would speak to Jeanine, seeing her as smart and white. One of her critical care nurses noted in her chart that Foua and Nao Kao had asked that Lia be given medicine to fix her brain. Foua cried and chanted at Lia’s bedside. Then, one of the critical care doctors walked in and disconnected Lia’s intravenous lines and told Foua that she was doing it because Lia was going to die. Foua interpreted it as the doctor wanting to take Lia’s medicine away and give it to someone else. The doctor was merely following Dr. Terry Hutchinson’s orders and he thought the family had agreed to discontinue life sustaining measures so that Lia could die as naturally as possible. One social worker even suggested a local mortuary in an attempt to help the family cope. However, Nao Kao refused to listen and insisted that she be brought home. He had to sign papers again for his own daughter to die among family. Jeanine arranged the court order to allow the Lees to bring little Lia home. She still needed some supportive care, so they agreed that she could be taken to MCMC even though they really wanted her to come back to their apartment. And so Lia began to make her last journey.

Notes

This is the saddest chapter so far when the reader sees that the big one predicted by Dr. Neil Ernst comes to pass. It seems as if Lia had no chance to ever live her life happily and well, because of so many cultural differences early in the life. It comes down to taking this little girl home to die.