(story originally written in 2008)

“Want some skittles Liz?” Bella asked

Liz took one hand off the wheel of the car to grab the chewy, sugary orbs.

“Can I ask you a question?” Bella flipped her shoulder length wavy brown hair over her shoulder as she looked at her sister.

“What?” she replied to her sister through her mouthful of skittles. Liz stared straight ahead out of the windshield at the perfect spring day. She couldn’t help but wish she were going to meet Roger at the course to play a round of golf, instead of driving to school with her sister. However, Liz wasn’t sure if Roger would ever want to play with her again, since he broke up with her last week. After another moment pause Liz sighed, “come on little sister, spit it out, it won’t take all day to get to school.”

Finally, Bella quipped, “Would you be mad if I went out with Roger?”

Liz spun her head towards her sister, and her chin length black curls bounced up and down. Looking into Bella’s eyes she tried to judge whether or not her sister was being serious. They did tend to tease one another quite often; they were generally always laughing together. “My ex-boyfriend?” she asked. In the split second it took Liz to take her eyes off the road and glance at her sister she missed the slight bend in the road ahead.

The girls’ van crossed the centerline and collided with the front bumper of a beat-up, rusting Ford 4×4, that looked like it used to be bright red, and might still have been underneath the thick layer of mud and dirt that coated it.

The sound of crushing metal erupted into the peaceful and bright spring morning as the van flipped three times before landing in a cloud of dust in the ditch. The smell of burnt rubber nauseated Liz as she sat still in her seat, choking on the dust that was emitted from the airbag’s ejection. Not knowing what to do she whispered, “Bella, are you ok?”

When no response came from the passenger seat Liz was afraid to see what had happened to her sister. Finally gaining the courage, Liz looked in the direction of her sister before she crying out, “Oh my god! Help! Someone call an ambulance! Call 911 my sister’s not moving she’s hurt bad!”

When the paramedics arrived one immediately took Liz to the back of the ambulance to start checking her over while the other stayed close to the van checking the condition of Bella.

“Shit, she’s posturing! Call a chopper!” The medic called from the van back to his partner.

Forcefully pushing past the paramedic in the ambulance Liz ran back to the van, grabbed the medics arm and tugged pulling him to face her, “wait, what’s posturing? Is she gonna be ok? She’s not gonna die is she? Did I kill my little sister?”

“Stand back young lady I need to make sure I can stabilize you sister’s neck before I remove her from the car.”

“But what’s posturing? Why do you need a helicopter? Where are you taking my sister, can I go with?”

“Sam, will you help me please?” The medic called again to his partner, “get this girl outta here!”

The other medic came forward to rest a well-callused hand on Liz’s shoulder “Lets go sweetheart I need to finish checking you over,”

He led Liz, with difficulty, back to the ambulance as she continued to resist leaving her sister’s side. “Come on, hop up on the stretcher miss, I’ll tell you about posturing while I clean up those scrapes.”

She grudgingly sat down on the edge of the stretcher, “what’s posturing? Is my sister going to be OK? I didn’t kill Bella did I? She’s not gonna die right, she’ll be ok?”

“OK,” the medic said as he took out a bottle of alcohol, some cotton swabs, a few squares of gauze, and a roll of tape setting to work on the scrap oozing on Liz’s chin, “Posturing is what happens to your body when you severely hurt your nervous system, so your brain and spinal cord, try to stay still,” he started as she winced at the touch of alcohol to her cut.

“But how do you know she’s posturing? Will she be ok? There’s so much blood over there, please tell me she’s gonna be ok!”

“Just relax honey, you’re gonna be fine…”

“But what about Bella?” She interrupted.

“I can’t say what’s gonna happen to your sister, she’s hurt pretty bad, that’s why we’re airlifting her to a trauma center. Stay still now, almost done.” The medic patted her knee and continued talking to her in a soft, soothing voice trying to keep her calm.

After using the last piece of tape to fasten the gauze over her chin he finally answered Liz’s pervious question, “My partner knew she was posturing because of what her body was doing. Her arms are curled in towards her chest and her legs are extended straight out. It looks almost like she’s halfway in the fetal position, do you know what that means?”

“Yeah, of course I know what that means, babies are in the fetal position before they’re born, when they’re still inside the mother.” she snapped.

“Yes that’s right,” the medic said. “So that’s how we know that she’s posturing. The hard part is what comes next though, you usually only posture like that when you have a really severe TBI…”

“What’s a TBI?”

“Traumatic Brain Injury, it’s the same thing as a concussion only its more severe.”

“Oh,”

“So, because it’s a severe TBI we need to get her the right kind of help as soon as possible. The closest place that has a neurosurgeon, someone that operations on the brain,” he clarified the term quickly figuring she would end up asking anyway, “is in St. Paul.”

“My grandparents live in St. Paul, that’s a pretty long drive won’t it take a while to get there?”

“Well if we drove yes, it would take about 45 minutes, but we don’t have that much time.”

“What do you mean? Is she gonna die in less than an hour or something?” Liz was losing her calm again, she was scared and trembled with agitation.

“I don’t want to scare you sweetheart, we are doing everything we can to help your sister but if we took the time to drive her all the way to St. Paul, I’m not gonna lie to you, she may not make it. That’s why we’re calling a helicopter, it takes a lot less time to fly to St. Paul than it does to drive. The chopper will be able to get her to help quickly enough to hopefully save her life.”

“NO! Please, can I go with her? I want to stay with my sister, can I go in the helicopter with her?” She cried.

“Well hon,” the medic began, “usually when it comes to this kind of helicopter there isn’t too much room for extra passengers, plus I think you should go to the hospital too and get checked out by a doctor. You could have a concussion.” he responded.

Terrified, Liz was sobbing as she tried over and over to reach her parents on their cell phones at work. Each time she was unable to get through she became more and more frantic.

“Sweetheart calm down, you’ll get a hold of them I’m sure, we need you to calm down and sit over there on the side of the road so we can get your sister ready to bring over to the high school.” the medic said putting his arm around Liz, trying once again to calm her.

“Why are you going to the high school? I thought a helicopter was taking her to the hospital?” Liz’s confusion helped to momentarily calm her.

“Well the closest helipad is too far away for us to risk driving there, and the road is too narrow for a chopper to be able to land right here,” he continued telling her about how they would be transporting Bella to the high school football field where they would meet the chopper.

“Oh…”

After Bella had been loaded into the ambulance the medic drove the short 2 mile distance to the high school. Liz finally got through to her mom just as the chopper left the field and disappeared into the sparse clouds.

After the chopper was gone the paramedics brought Liz to Fairview hospital, where her distraught parents met her. After being checked over by a doctor it was determined that she had not suffered a concussion. Bella and her parents then left for the St. Paul hospital Bella had been taken to.

Upon their arrival they were shown into a small family waiting room for the ICU on the eleventh floor. They waited close to an hour before hearing any news concerning Bella’s condition. During the wait, being the only family in the waiting room at the time, it was eerily quiet apart from the intermittent sobs from the girls’ mother. Liz tried to keep her attention on the People Magazine she found on a small, octagon shaped, table in the center of the room but she kept glancing guiltily in the direction of her mom and dad.

Her parents, Tom and Jane, sat huddled together a few chairs away from Liz. Her father was whispering words to his wife that only the two of them could hear, while tears freely fell from her eyes onto Tom’s blue dress shirt, turning the fabric a darker shade of blue where the tears landed. Tom’s eyes, shielded by silver wire rimmed glasses, were locked on his wife, concern wrinkling his brow as they continued to wait.

Finally, the door to the waiting room opened and a large man with silver specked brown hair, wearing oversized bifocals and a long white coat approached the family.

The three stood as he briskly addressed them, “My name is Dr. Partington, I am the neurosurgeon taking care of Bella…”

“I’m Bella’s father T…” Tom started to respond, only to be interrupted by Liz.

“Hi doctor I’m Liz, Bella’s sister. I was driving the car when we got in the accident. These are my parents Tom and Jane, how is my sister will she be ok?” her questions were asked quickly not allowing Dr. Partington any time to acknowledge the introductions.

“Well, Bella is stable at the moment,” he said, “I performed emergency beside burr holes and placed her in an induced coma for an amount of time that is yet to be determined,” Dr. Partington addressed the teenager in the bluntest manner possible

“Wait, what are burr holes?” Liz’s mother asked the doctor.

“Where is my sister can I see her?” Liz ignored her mother’s question.

“I apologize, let me try explaining things to you again.” Dr. Partington said deciding to answer Jane’s question first, “Bella has suffered a severe TBI…”

“Yeah I know the paramedics told me that,” Liz interrupted, “when can I see her?”

“Ok, well that was because of whiplash,” the doctor continued to ignore the teenager, “when that happened her brain bounced off of both the front and back of her skull, severely damaging both the frontal lobe and the parietal lobe, which is the rear top of the brain…” Dr. Partington then talked about how Bella’s brain swelled after colliding with her skull, before describing the details of a burr hole procedure, “in order to give your daughter’s brain the amount of space it needs until the swelling decreases I had to attempt a surgery called bedside burr holes. Basically that means I used a cranial drill to make three small holes in her skull; one to let the spinal fluid drain giving her brain more space, one was to let the pressure out of her skull, and the third was so that I was able to insert a pressure meter to measure her brain pressure as she begins to heal.” Dr. Partington finished his long monologue to the girls’ parent’s rapt attention.

“Is she gonna get better? You still haven’t told us how bad she’s hurt and when I can see her!” Liz said, rolling her eyes and losing patience with the surgeon’s bedside manner.

Dr. Partington described to Liz and her parents about why he could not tell them whether or not she would survive. He said that during the first seventy two hours it is the key time for them to monitor Bella, however he said that as serious as her injuries seemed to be it did not look promising. He told her parents that they should start preparing themselves for the worst. After his statement Dr. Partington turned and left without another word.

Three days later Bella still unconscious in the ICU. Liz saw Dr. Partington in the hall as she was waiting for the elevator to go down to the first floor cafeteria. She needed to get cups of coffee for her parents and a coke for herself.

“How’s my sister doc.? Is she gonna make it?” She asked him.

“I dunno,” he said shrugging.

“What do you mean you don’t know?”

“I mean I…don’t…know!” He spat, putting emphasis on the last three words.

“But, you said that the first seventy two hours are key, well its been three days that means something should have changed. Is my sister gonna live?” Liz was close to tears.

“I don’t know what you want me to say kid, what do you want from me? Yesterday she was this close to death,” he said raising two fingers about an inch apart, “and today she’s about this close,” he fractionally moved his fingers further apart, maybe a half centimeter. By now a small crowd had grown around the two and were listening to their confrontation.

While Dr. Partington seemed to be a bit embarrassed, glancing over his shoulder at the crowd and somewhat shuffling his feet, Liz wasn’t the least bit ruffled. She had a question and she wasn’t going to let him get away without answering it, “But you know something! You’ve been monitoring her brain or whatever for the last three days, doesn’t that telling you anything?”

“When I said the first three days are key, I mean that her brain will continue to swell for those first three days; so its most important that we keep a close watch on her brain pressure during that time. After that the swelling doesn’t just disappear, it stays consistent for a while before it starts to decease.” He told Liz, his voice softening as tears began to show in the corners of the girl’s eyes. He said that if Bella survived the rest of the week she would probably make it, but he also said there is no way of telling what she will be like if she ever comes out of the coma, “Until she wakes up, if she wakes up, we have no way of knowing the extent of her brain damage. We just can’t tell yet.” He finished the explanation as he entered an elevator, and just as Liz’s elevator arrived on the opposite side of the hall.

After another few days had passed Dr. Partington confirmed that Bella would indeed survive, however he still stressed that there was no way of knowing the extent of her brain damage, and her mental state, until she woke up. He warned Liz and her parents that there was still a high risk that she may never come out of the coma.

On one of the last days in June Bella finally opened her eyes to a sea of family and friends. Tears began to seep from Liz’s eyes as she watched the breathing tubes being removed from her sister’s mouth, and smiled as a nurse used a washcloth to wipe the saliva dripping from her chin.

“Hey sis, how ya feeling?” Liz asked when she was finally able to approach her sister. She took Bella’s hand and held it, stroking her clammy skin softly. Bella quickly pulled away and screamed.

“No! Get away from help, help!”

Startled, Liz leapt back and cried out to her parents and Dr. Partington, who had just entered the room, “Why is she scared of me?”

“She’s been in a coma for almost a month, she hasn’t spoken to anyone or realized what has been going on during that time. She’s going to need extensive speech therapy before she will know what she’s saying or who she’s saying it to. Relax Liz, just give your sister some time to adjust.” He replied in a calm and concise tone.

“Well how is she? Do you know how much brain damage she has yet, will she make a full recovery?” Excited Liz continued to drill the neurosurgeon.

“Well, seeing as she just woke up about ten minutes ago I couldn’t really tell you,” he said rather snidely, “I need to talk to her and observe her for a while before I make that declaration.”

Two weeks later Bella had been transferred downstairs to the fourth floor, where she spent all day everyday in several different types of therapy. In her room, Liz and her parents sitting on one side, Bella sitting on top of her bed, she still did not seem able to recognize her family by face or recall their names.

“Bella, when you get out of here we’re gonna go golfing together ok?” Liz started, trying to urge her sister to remember something. Bella didn’t respond. Just then Dr. Partington walked into the room.

“So miss Bella, I’m Dr. Partington. I am the doctor that worked with your brain,” he reminded her, just as he did every day, because her short-term memory was almost completely non-existent, “how are you feeling today, do you have a headache?”

“I feel fine thanks. Nope my head doesn’t hurt. Why are you calling me Bella? Where am I?” Bella asked the doctor.

“Your name is Bella, you are 15 years old, you are in the hospital. You were in a car accident almost two months ago,” he replied, again repeating the same story they all had every day since she woke from her coma.

“Who was talking to me when you came in? Do I know that person?”

“The person talking to you is your sister, she’s been by your side every day since you came here. Do you remember?”

“Umm, I’m not sure. What’s my name again?” Bella asked.

“Bella, your named is Bella!” Liz snapped, unconscious of her tone.

Turning to Liz and her parents Dr. Partington confirmed something that Liz and feared since the day her sister awoke, “It seems as though Bella is suffering from some amnesia.”

“How long will that last? Will she ever remember everything again?” Liz asked.

“I’m sorry but I can’t say. She will need to be evaluated some more by her therapists. We’ll know more in a few days probably.”

A week later, having used all of their vacation time, Liz and Bella’s parents returned to work. Against her parent’s wishes, Liz stayed with her sister. They had told her to return to school but Liz refused to leave her sister alone. She wanted to be there when Bella started to remember. She stopped at the school a few days earlier, and after talking to all of her teachers collected the work she would be missing for the next week.

Sitting in the hospital room at a table Liz was working on her calculus homework, again thinking of Roger. He had visited Bella several times since the accident, bringing with him a new gift for Bella with each visit; however he never said a thing about going out with Bella or being interested in her. While that gave Liz some hope, it bothered her even more because he never said much to her besides telling her how sorry he was that the accident happened, and that he was praying for Bella.

Liz’s eyes glazed over with another batch of tears, blurring her vison of the problem she was trying to figure out. The three in x(dy/dx)3=-y was starting to look like an 8.

“Bella?”

“Yeah?” She responded.

“Do you remember me at all yet?”

“Um, I’m not sure, I think so maybe. I share a room with you at home right?”

“Yeah! OMG I am so glad you’re starting to remember! We used to talk all the time about everything, I’ve missed talking to you so much!” Liz squealed, abandoning her homework to perch herself on the corner of her sister’s bed. The look on her face showed her excitement. Her green eyes, that moments before were saturated with unshed tears, now glowed and were so round and eager it looked like she was a kid going into a candy store for the first time.

“Do you remember anything else? How about Scooter and Buddy, do you remember them?” She prompted, referring to the girls’ beloved cats.

“Yeah I think I do. Scooter is…hmm, is he black, gray, or orange….” Bella struggled…“gray I think. And Buddy orange…am I right?”

“Yup!”

“And Scooter’s skinny and Buddy’s fat like Garfield, right again?” Bella added, quickly beginning to get excited too.

“Yup! God I’m so happy I’m getting my sister back!”

“There is one thing that I don’t remember anything about though…” Bella said to her sister.

“Oh yeah? What’s that?” Liz asked.

“The accident. I remember the day before the accident, I think I was in the library at school and I was talking to some guy about going somewhere, I’m not sure who. I think it was that guy that’s been coming to see me a lot.” She tried to recall.

“Which guy?”

“Um, the one with the dark wavy hair and the freckles all over his face. I think his name started with an R maybe?”

Liz didn’t know how to react. Was this confirmation that Roger liked her sister more than he liked her or was Bella just mistaken?

“Liz, you remember what happened right?” Her sister asked.

“Unfortunately,” she answered. Liz withdrew back to her math homework feeling dejected.

“I remember the day before, and the next thing I remember is today. I know I’m getting better but it feels like there’s a whole part of my life missing. Will you tell me? I want to know what happened.” Bella pleaded with Liz.

Liz remembered exactly what happened. Even two months later she wasn’t sure how to answer the question Bella asked that morning. How would she feel if her little sister went out with her ex-boyfriend?

“Umm….not today Bella, maybe we’ll talk about it tomorrow.” Liz deflected, hoping that by the next day one of two things would happen. Either she would finally figure out how to answer her sister’s question…or her sister would forget she ever asked. As reprehensible as it was, Liz was kind of hoping for the latter.