Read an Excerpt:
“We do not technically characterize your sister’s condition as a coma. We believe that she is in a persistent vegetative state, which we sometimes call a wakeful coma, and PVS for short, like I just told you. Physiologically, her brain has been severely damaged. The function of the cerebrum or the upper part of the brain has been impaired, as has the cortex or the outer layer of the cerebrum. This outer part is believed to be responsible for our conscious activity. Damage to both most likely was caused by the trauma to her head caused by the fall,” he explained, trying not to sound patronizing.
It worked. April’s face loosened.
“However, your sister’s brain stem, the lower part connected to her spine, is still functioning. Coma patients often have brain stem damage, which renders them unconscious and without the same physical functions that your sister has because the brain stem controls involuntary functions like breathing, digestion and reaction to pain. Even blinking and sleep-wake cycles. You know, that type of thing,” he continued. “As a result, PVS patients like your sister have periods of sleep and wakefulness. They flinch from pain and may react to noise or follow movement with their eyes. But their responses are of limited duration and seem to lack purpose.”
So, she’s not brain dead,” April asked flatly, as if somehow disappointed.“No, she is far from brain dead. She has partial brain function. Right now, she is in a wake cycle. Notice how her eyes are open and her mouth is moving,” he said pointing to me, as if on display—the poster child for PVS. I didn’t realize my mouth was moving. Learn something new every time this guy talks.
“Watch this. She can respond to certain stimulus. She will grasp my hand when touched and it will appear that this is a voluntary response.”
With that, he walked over to my bed and said, “Hi there, Jude” and then placed his thick hand in mine.
A sensation shot through my arm. Nothing replaced the human touch. Oh, did it feel wonderful. The feel of flesh upon flesh was one of the things I missed the most. Even though I was not a touchy person by nature, Frances was. She was forever hugging me and grabbing my arm when we walked together. I guess not having that skin-on-skin feeling underscored its importance. Elated, I felt I could jump up and run around the room.
Personal touch had become so unfamiliar to me in the short time I was there. When I was touched, it was merely the function of cleaning my body and adjusting my limbs for physical therapy. Seems as time has gone by, people rarely just touch me, stroke my head or hold my hand. I wanted them to want to feel close to me. Frances had been the only one to consistently hold my hand since I’d been admitted. While Jeffries and some of the nurses were good about talking to me as if I were mute, and once in a while, patting my hand or rubbing my arm, there was no prolonged touching.
But this was a demonstration. I had forgotten. As he slid his hand into mine, I watched as my hand reflexively folded around his, without any effort on my part. I seemed to have vacated my own body right after the fall. Now it belonged to this automaton that responded mindlessly to stimuli and reacted instinctively. I was reminded I was no longer in control.
I longed for him to keep it there, but he abruptly pulled away.
The tears welled up inside me, but of course nothing emerged. It had been a long time since I felt like crying, and now, even if I wanted to, I couldn’t. April stood absorbed in the moment, consciously taking it all in.
There you have it, April. Now you know. I could have explained it much better myself if I could have actually talked. To my way of thinking, it was a simple matter of being fully cognitive and aware but simply not being able to move. It’s like I’m paralyzed all over, including on the inside, I wanted to tell her. It’s like being frozen, yet hearing everything, seeing everything, and at the same time being completely ignored. Sometimes I am here, connected to this cumbersome flesh; other times, I drift in an unknown place, my sense of self slowly vanishing—no, no, merging into nothingness. Hard to describe, but so very natural to accept.
About the author: Lenore Skomal wants you to eat her books. Her passionate desire is to touch your heart, inspire you, and luxuriate in the world of the written word. She is an award-winning author with the single goal of resonating with others. Winner of multiple awards for blogging, literature, biography and humor, her catalogue spans many genres. With 30 years of writing experience, 18 books published, a daily blog and weekly newspaper column, the consistent themes in her work are the big issues of the human experience and adding depth and voice to the intricacies involved in living a multi-dimensional existence. She has won many Society of Professional Journalist awards, the Whidbey Island Writer's Conference honorable mention for best fiction, Writer's Digest 73rd Annual Fiction Contest, New York Public Library's Best Books for Teens 2003, and most recently, the 2012 Next Generation Indie Book Award for humor for “Burnt Toast.,” her first anthology of her award winning humor columns. From journalism, to literary fiction, to humor and biography, her writing is consistent, if not in genre, then in message.
Lenore Skomal is the author of the recently released novel Bluff. As an author, Lenore wants you to eat her books. She wants you to chew them in your teeth, savor them on your tongue, breathe them in, and feel her words in your skin. Her passionate desire is to touch your heart, inspire you, and luxuriate in the world of the written word. Winner of multiple awards for blogging, literature, biography and humor, Lenore Skomal’s catalogue spans many genres. With 30 years of writing experience, over 17 books published and a daily blog, the consistent themes in her work are the big issues the human experience and adding depth and voice to the intricacies involved in living a multi-dimensional existence. www.LenoreSkomal.com
To the medical world, I was a host body, surviving only to bring a new life into the world. And while I wanted to die more than anything in the world, I never wanted this. No, I never wanted to cease to exist. This was the worst death of all.
Research in the making of Bluff by Lenore Skomal
Like most novelists, I believe having a great story line is the best place to start but it certainly doesn’t make the novel complete. For BLUFF, a story about a 40-year old coma pregnant coma patient teetering on death, the plot needed to be vetted by medical professionals. I knew this going into the writing and thankfully my skills as a journalist came into play.
It was absolutely essential for me to interview trauma surgeons, palliative care physicians, ICU nurses, pediatric care physicians, rape counselors as well as hospital administrative staff in order to get the most authentic information to provide the bones of what would be the storyline.
My goal was for the reader to feel the stress of the E.R. to hear the way doctors really talk to and about patients, to taste and smell the sights and sounds of the ICU and to experience the time warp that only hospitals create.
Toward that end, I made sure to interview those who are in those situations each day. And while none of them had to deal with a pregnant coma patient, they all took great care to put themselves in that hypothetical situation.
Because of my parent’s deaths—both of whom died in hospitals after long term illnesses—I had my own perceptions about the linoleum floored halls and protocol, which I drew from liberally. But there were large gaps in terms of the medical handling of having my protagonist, Jude, fall from a cliff and end up in a coma. In order to reconstruct the accident and the resulting injuries, I had long discussions with a trauma surgeon. The exactitude was important to me, not only as an author but also as a former journalist. After all, I was asking a lot of my readers, in terms of taking a leap of faith when it came to accepting the seemingly highly implausible premise of the narrative coming from a coma patient. Having an accurate and reliable description of detail, starting with her fall and proceeding through the time spent in the hospital was essential for several reasons.
First and foremost, it added much needed credibility. I didn’t want to lose my readers, especially those who were sticklers for precise details. (I also didn’t want to bore the snot out of them, so I edited these parts continually to streamline yet not gut them.)
As a writer, I know how easy it is for someone to get derailed because something in the story doesn’t smack real. I also believe that with authenticity comes the stability of boundaries. The reader can trust me because I am not just making up crap in my head and trying to slam it down their throat. They can feel safe with my storyline because it is believable, it is real, and that’s where the trust comes from.
And in the end, I do believe we have a responsibility to maintain that trust with our readers, or run the risk of losing them for good.
About the Author
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Jude Black lives in that in-between, twilight place teetering on death but clinging to life in order to bring her baby into this world. Only she knows the circumstances surrounding her mysterious fall off the bluff that landed her in the hospital being kept alive by medical intervention. Only she knows who the father of her baby is. In this poignantly crafted literary novel, the mystery unfolds and the suspense builds as the consequences of Jude’s decisions threaten to reveal everyone's deceptions, even her own. Bluff offers a sensitive look at essential questions such as the value of human life, the consciousness of those in a coma and the morality of terminating life support. At the core is the story of a tragically misunderstood woman who finds peace, acceptance, understanding and even love on her deathbed.
Kindle Edition: http://www.amazon.com/gp/product/B0095YE65M/
Paperback Edition: http://www.amazon.com/Bluff-Lenore-Skomal/dp/147819247X