TUES. 07/05/11--I.C.U. DAY 8...ONE YEAR LATER...DEPARTURE FROM FREEMAN....ARRIVAL AT BARNES JEWISH HOSPTIAL

On Day 8 things happened rather quickly.  Another conversation with the Pulmonologist resulted in the mutual conclusion that Dad would have a better chance if transferred.  Barnes Jewish Hospital in St. Louis was an option, University Hospital in Columbia was a possibility.  A few others came up, but Mom and I expressed that our top priority would be for him to go where he would have the best chance.  Barnes seemed to have the best resources, and after a quick late-afternoon phone call, we were notified that Barnes wanted to accept Dad, they had a bed available., and Dad would be leaving by ambulance in one hour or less!! No time to reconsider or back out now!!!

Mom and I scrambled to get back to the truck stop room, grab a few quick items for the trip, and get back to Freeman, passing the ambulance with Dad departing as we were returning.  I made a U-turn and followed the ambulance transporting Dad, keeping it within view until the van we were driving very nearly ran out of fuel a half hour or so outside of St. Louis.

After fueling up with the speed of a pit crew, we got back on course, and managed to arrive at Barnes not long after the ambulance.  Barnes at 2am was a very strange place....the ER entrance had all manner of big city trauma and medical business going on, and after negotiating temporary parking, and getting Mom in a wheelchair up to the ICU, we were notified that Dad's bed had been filled by multiple cardiac arrest patients, and Dad had been moved to "89-ICU" on the other side of the Barnes campus.  The ambulance crew and Dad and all of the life-sustaining equipment had already arrived and been turned away from the same spot we were. Still trying to understand why a hospital was being referred to as a "campus", I wheeled Mom back downstairs and wondered what in blazes I had gotten us into.  Dad had apparently come all of this way to be sent to some sort of 'overflow' I.C.U. or something in who-knows-where in a vast hospital "campus"!!!

After getting some directions, arrival in the new location seemed even weirder...the area that I would find out later to be the prestigious Center for Advanced Medicine at that 2am hour seemed more like a vacant lunar landscape...with the only evidence of our successful arrival being the parked ambulance that we had followed from Joplin.  A lone security guard gave Mom and me some hand-written name tag stickers and what seemed like complicated directions down a windy hallway, up some elevators to the extremely arbitrary-sounding 8th floor....

Once there, we wandered unrestricted into some open doors of what seemed like an empty I.C.U. of sorts...with most of the lights off and apparently nobody there to greet us or keep us out, other than the ambulance crew that were packing up their gear.  We thanked them for getting Dad up there so quickly, and they stated that he remained mostly stable during the trip ("Mostly?!! No wonder they drove so fast!").  We then wandered down the hallway and found the room Dad was being moved into and found two nurses that politely but hastily asked us to wait outside in the waiting room back near the elevator. What kind of a place was this???!!!

Before we left Freeman, I had spoken with one of Dad's best lifelong friends and Navy flight buddies, A.B. Shuman to give an update on Dad's status....I asked for cartoon ideas, since Abey had always had a brilliant wit that cracked Dad up unceasingly,  I was sure he would be good for a cartoon or two or three to lift Dad's spirits.  One of the first things he suggested was a sort of unofficial logo that Dad and his flight crew had....the "Flying Eyeball" a popular motorcycle emblem that had become popular on American roadways after somebody invented it.  Cars, Motorcycles, and Tattoos were probably the 1960's version of going "viral" and Dad's flight crew related to it quite naturally, since they were engaged in Anti-Submarine Warfare operations and fancied themselves as an "eye in the sky" of sorts. 

The cartoon I chose for the Dad's transfer day signified a change in theme....moving to Barnes kicked up the stakes, and "upped the anty" of our efforts to get Dad off that vent...we weren't messing around...and it was time to go from drawings of Dad as different superheroes....to drawings of how Dad actually WAS a superhero!

The Flying Eyeball was the first such drawing...a symbol of Dad's flight squadron time, the bonds he made with his squadron brothers, and of one heck of a fast drive we all did on I-44 from Joplin to St. Louis to get Dad to a higher level of care....I truly believe it would have made any rebel-biker or hot-rod maniac proud...!!!!

MON. 07/04/11--FREEMAN I.C.U. DAY 7...ONE YEAR LATER

So after an incredibly strange Day 6, at 1900 hours we were in Day 7...which happened to be the Fourth of July...a day of much needed celebration and hope....for the residents of Joplin....and for Mom, Dad, and me... no additional creepy crawlers presented themselves in any of Dad's tubing in Day 7...and repeated washes down into Dad's lungs and Stomach presented no additional monsters.  "Inky and Blinky" in the canister seemed to be doing okay, crawling around doing their thing...and Dad seemed just to continue to hold his status....the repeated X-Rays showed a possible very slight improvement occurring in the fluid that had accumulated in Dad's lungs, but this was most likely wishful thinking.  We all wanted things to be improving, but the data was not supporting our wishes or prayers.

I noticed that Dad's internist, Dr. Ali, had been making rounds and staying late into the evening charting and obviously straining with all he had to figure out if there was some avenue we had overlooked, some treatment we had not yet found...but thus far it was to no avail.  Dad's Pulmonologist leveled with me....the bugs had everybody stumped, but the Infectious Control Doc flatly ruled out any possibility that those types of organisms could have originated, or even survived for any period of time inside Dad, and were at most probably unrelated.  The source of Dad's Atypical Pneumonia had not been identified, and we might want to consider treatment at another facility that had more resources that they did not possess at Freeman.  That was all I had to hear...."By all means, Doc, if you think some place can give Dad a better shot, let's go there!"  and to me we couldn't get there fast enough if Freeman felt they had reached a dead end!!!  Unfortunately, the Fourth of July was going to be a near-impossible day to call and get a transfer approved, so we would be waiting it out for another night...

Joplin and the surrounding community came together on the North side of town for a Fourth of July fireworks celebration that was perhaps the most meaningful Joplin had ever had!  Mom and I spent some time with Laremy, Phaedra, Gayle,and their girls, which served to lift our spirits a bit. We left at dusk, and I even managed to talk Mom into parking  for a bit to watch the fireworks show overhead. It wasn't long before Mom changed her mind, and simply wanted immediately to get back to Dad, which I couldn't blame her for. She simply couldn't enjoy any of the fireworks without Dad while he was back in the room at Freeman.  The Fourth of July Night Sky was on fire high above Joplin, lifting the hearts of several thousand people below, but all Mom could think about was returning to Dad's bedside.  Herself a very experienced Nurse, Dad's appearance, and the lack of improvement up to that point were painting an increasingly dark picture of Dad's outcome. She was becoming increasingly depressed, and highly distraught as she saw him there in the room. Leaving a vast array of amazing fireworks behind us as we drove South on Main Street back through the dark tornado damaged area toward Freeman seemed meaningful somehow. I felt like all of the fireworks were somehow for Dad, celebrating that he was there with us for at least another night...the occasional lone starburst rose up above the town in various places around us, and my pride in Joplin and in our nation's ability to endure amidst adversity swelled up within me.

My drawing for the day was easy to come up with....Dad as Captain America for the Fourth of July Holiday...but, of course, LCDR America was a bit more accurate, so I adjusted accordingly, and filled the background with the Stars and Stripes.

Mom and the drawings in the Freeman I.C.U.

SUN. 07/03/11--FREEMAN I.C.U. DAY 6...ONE YEAR LATER

During Day 6 things took a turn for the surreal...I had already spent quite a lot of time searching google on my phone about different types of pathogens and parasites that could possibly be causing my father's respiratory deterioration.  The possibilities seemed endless, and all frightening, but would almost be welcome if one could be identified as a step toward curing  Dad.  A lot of public attention had begun to focus on fungal infections among tornado victims.  Mucormicosis was the name that identified a deadly tissue-eating fungus found in numerous victims.  It was found to be so lethal it's only cure was surgical removal. The google searching I first did identified similar fungal infections as being cutaneous, pulmonary, cerebral, or systemic.  Up to that point, only the cutaneous version of the deadly fungus had been identified in Joplin.  To my knowledge, thus far only the cutaneous form of it has been identified in Joplin tornado victims to date, more than a year later.   Still, the inability to identify the root cause of Dad's pneumonia in that first week in the Freeman I.C.U. makes me wonder if somehow a fungal infection could have been an influence.  The guys on the fire trucks back in Columbia had google at their disposal as well, and it sounded as though they had taken for granted that Dad's respiratory illness was fungal.  To this point, I don't know if it can be completely ruled out.

But there was one thing that definitely presented as a foreign organism that I myself discovered on Day 6....and it is the weirdest thing I have ever heard of in an I.C.U. anywhere!!!! I'll explain....
When I wasn't helping Mom get around or supporting her in her daily agony seeing Dad suffering on the vent, or googling new nightmarish scenarios of what might be in Dad's lungs, or drawing, I sat there next to Dad...for hours....holding his hand....and doing a continuous cycle of staring at his face, and then starting at the monitor displaying his vital signs, and then staring at the ventilator......I did this continuously, not in any particular order....racking my brain trying to figure out the puzzle of what was keeping Dad from improving....and then I saw something that didn't seem to make sense!  I saw movement in Dad's ventilation tube!  What in the $%#* was that?!!! Something was crawling!!!! There were several small white organisms that resembled tiny maggots, both crawling in Dad's Oxygen supply tubing, and also in Dad's NG tube coming from his stomach!!!!  I called the nurse in and asked if the tubing was a closed system, and showed her what was going on, and we got rushed out, while Freeman nurses, Docs, and the Infectious Control Doc all came in!!

It didn't make sense, and for the most part, the Freeman staff seemed stumped....but though extremely freaky and seeming worthy of a Science Fiction B-movie, I was heartened that this might explain something about why Dad was not improving thus far!!!

They let us back in, after doing Pulmonoscopy and Gastric exams, which showed that nothing was crawling around inside Dad. But this was definitely a very weird twist in the story!! Leave it to Dad to find a way to be unique!!!  Tubing was replaced, and the hope and dominant theory was that something had originated somehow in the tubing itself.  In the morning the off-going nurse checked and found two more of these little organisms crawling once again out of Dad's Oxygen tubing...and was kind enough to put them in a small canister, where they crawled around actively, presumably looking for something to eat, since Dad was no longer available on the menu.

Not quite understanding what was going on, but hoping that it might lead to solving what was Dad's root cause, I drew Dad as the Silver Surfer....the most cosmic and alien of any superhero I could think of to commemorate the strangest experience we had yet up to that point.

SAT. 07/02/11--FREEMAN I.C.U. DAY 5...ONE YEAR LATER

As Day 5 was coming the 1900 hour mark, things were not improving, though Dad continued to fight on.  He seemed to be fighting the ventilator settings less, and his vitals seemed to be holding.  As Dad was so reliant upon technology that was keeping him alive, Iron Man seemed like a good subject, and I recall wanting to take more time to color in the entire page with some bright contrasting colors that he would be able to see really well, and I was wanting more than ever for him to be able to look up and see the artwork thus far...

FRI. 07/01/11--FREEMAN I.C.U. DAY 4...ONE YEAR LATER

The end of Day 4 arrived and it was becoming increasingly clear this was not going to be any sort of a quick and easy positive resolution.  Dad was not only failing to improve, but seemed to become more and more agitated unless he had plenty of medication to keep him relaxed....at a few tense moments, as Dad's heart rate and blood pressure shot up to dangerous levels, I could imagine him "hulking out" and turning into a big green monster, ripping out all of the equipment and bursting through the wall and bounding out of the hospital.  I'm sure if he could have, he would have....but drawing him as the Incredible Hulk seemed to capture what I suspect was his overall sentiment at that point...he was pissed off!!! Not happy to be there at all! And Mom and I were pissed right there with him at the absurdity of the whole situation thus far...and our frustration that nobody could identify the cause of Dad's pneumonia, and why nothing seemed to be helping.

In my search for more bright colors that would be viewable by him on the wall in his field of vision, I covered the entire paper....and did a bit more experimentation with combining colors....I already had discovered a green, but found I could get a dark blue 'purple' by combining the light blue and pink highlighters, and the pink and yellow brought an orange.  it felt like I was starting to get the hang of this highlighter art thing...

THURS. 06/30/11....FREEMAN I.C.U DAY 3...ONE YEAR LATER

As Day 3 came to a close, I recall that we were all perplexed.  Dad was getting blasted with lots of antibiotics, and they were taking cultures in an attempt to determine the source of his "Atypical Pneumonia" that was steadily worsening.  Dad showed little or no improvement, and it seemed to me like every breath that he was taking was about as easy as it would have been to go climbing up a wall.  Even the vent settings were hard to calibrate, since Dad seemed to fight them, seeming to want to breathe on his own.

As Dad crawled forward through time, I drew him as Spider-man, now realizing with certainty that I was going to draw another cartoon for Dad every additional 24 hours that he made it.  At this point, the drawing was giving me something to do there at this bedside.  I drew them while sitting there next to him, with the clipboard I was using resting on his bed, right there by his legs, one of which I was often gently holding on to. It really didn't matter to me the "quality" of the drawing, but rather that they had bright colors that Dad would be able to see in his field of vision, regardless of how blurry it might be, at whatever point he might able to see himself depicted as the superhero I knew him to be...

WED. 06/29/11....FREEMAN ICU DAY 2...ONE YEAR LATER

Coming up on day two...we had originally first seen Dad on the ventilator just after 7pm that evening of June 27th, so 7pm was a significant time of day from then on...it signified another full 24 hours....and I figured I might was well do another drawing to show that Dad had negotiated another full day on the vent...every 1900 hours from that point on was my goal for another day there with Dad...

That second day, they pulled back some on Dad's sedation to check his mental status, and we were able to make eye contact and got recognition....Dad looked really unhappy, uncomfortable, and barely able to tolerate it,  but it was great to see that he was still there with us.  Mom innocently asked, "Are you okay?", to which Dad nearly managed to roll his eyes as if to say, "Yvonne, do I look okay?" So far as I could tell, Dad was able to hear every word we said to him and there was no telling at what point--if ever--that he failed to hear us.  So from then on, I was determined to speak to always speak to Dad as though he was awake and present with us, and remind him of encouraging words like, "We'll have you out of here soon Dad,"...."Your Pulse Oxygenation is looking better Pops, keep up the good work", and "You've been in worse scrapes than this..."  I was to continue this upbeat tone for the duration of Dad's time on the vent...and for most of the time, I still managed to believe that Dad was somehow going to walk on out of there just like he did back at St. John's 20 years prior.

Once Dad had completed his first 24 hours on the vent, his hands and arms began to swell up with fluid.  Shortly after the evening ICU nurse took over she let me know that they probably were going to have to cut off Dad's college ring, in order to keep his finger from losing circulation, and being damaged or eventually amputated.  By that time, his finger had swelled up so much that it didn't appear that there was going to be any way we could slide it off his finger, but I urged the nurse to avoid cutting it if at all possible. You see, that ring had special meaning to my father.

Dad was the first member of his family to attend college.  Indeed, his father, my namesake Walter Ray Goodman I, on his deathbed when Dad was a teenager, had among his last words told dad "Go to college."  Well, Dad managed to work hard in school and was awarded an appointment to the first class of the United States Air Force Academy in Colorado Springs.  Dreaming of becoming a pilot for many years, he was devastated to learn during his medical exam as one of the final stages in his appointment process that his vision was not 20/20...and in one fell swoop lost his Air Force Academy scholarship, his assurance of obtaining a job and military commission, and his dream of becoming a pilot.  No waivers existed for that first class--you had to be perfect.  I believe in retrospect that my father has proven to be way better than 'perfect,' but unfortunately the Air Force Academy missed out on the honor of having him.

After taking a year to regroup and attend some classes at Joplin Junior College (now MSSU), some of his buddies that had gone to the University of MO-Columbia found Dad while back in Joplin on break.  They essentially kidnapped Dad and brought him up to Columbia, where he got hooked.  He enrolled the next semester, and joined the Naval ROTC unit there, setting his sights on a commission as an officer in the United States Navy.

His father had lied about his age and left a long line of Methodist "circuit rider" ministers to join the Navy in World War I, returned to the Navy in World War II, serving with pride both times as a Machinists Mate, and attempted to re-enlist during the Korean Conflict, but was turned away for being too old.  Dad didn't have the benefit of a scholarship.  Though pops was a gifted Baritone singer, and was offered a full-ride vocal music scholarship, Dad 'stayed the course', and worked his way through college at MIZZOU in Political Science, a degree by which he could be commissioned as a naval officer, and continue our family heritage of naval service.  He got a small scholarship singing a solo for Handel's "Messiah" at the Missouri United Methodist Church, but essentially worked multiple simultaneous jobs to earn his entire tuition for college...no small feat at that time.  It meant that he had virtually no money, no time to sleep, nor even study, but he pulled it off with just over a hard-fought 'C' average. Dad wore that ring with pride from that time on, with probably twice the pride of any Annapolis graduate after all of their service academy travails.  Dad's fraternity, Pi Kappa Alpha, was engraved on the face of the gemstone, and reminded him of what were probably the only fun times he had at MIZZOU with what few breaks he had among his fellow brother "Pikes."  I knew this was no ordinary ring to Dad, and he would truly hate to see it cut off.

To add even more to its value, in recent years Dad had given the ring, his most prized possession, to Mom as a token of his love.  Mom's wedding band had been lost years ago, and Mom had worn the ring on a gold chain around her neck for awhile. Well, at some point Mom misplaced the ring, which undoubtedly disappointed Dad, but...what do you do, right?

One of the struggles I had in the days after the tornado was keeping Mom out of the house.  She seemed to keep going in to gather the things that were the most valuable to her that she acquired during 30+ years as a Nurse, and while traveling the world as a stewardess for Pan Am.  She had a tendency to fall down, trip on debris and disheveled items in the house, and was obviously very sensitive to heat and highly emotional about losing so many of her possessions.  Every time I turned my back on her, it seemed like she had run back into the house, and was trying her best to get hurt, overheated, and any of a variety of other dangers.  It was exasperating!

What I didn't know was that Mom believed that she had an idea where Dad's ring was, and went back in to look for it every chance she got ...determined to find it.  I don't know how she did it, dodging my protective attempts to keep her out, pushing aside and barking at restoration contractors that were boxing up and throwing away items and debris, and digging through the rubble, but she found it!!!!!!  And when she handed it to Dad, his face lit up like it was the best birthday surprise of his life!!! He couldn't believe it!  For my part, it said a lot to me about Mom's love for my father, as I found out that so much of the fussing Mom had done about trying to get back into the house was not for her own possessions, but for Dad's ring.

The ICU nurse took pity, and we determined we were going to safely get that ring off!!  She pulled every top secret Nurse trick out of the book....elevated Dad's arm up, wrapped tape tightly around his finger beyond the ring, and found the most slippery soap devised by man...and after several agonizing attempts.... VOILA!  The ring came right off unharmed!

In honor of this small victory for Dad, I made the Dad's second drawing depicting him as the Green Lantern...with the ring emblazoned with a "Pi Kappa Alpha" engraving just like his own....and embued with obvious magical superpowers, like I have no doubt the ring had for Dad as a reminder of what he accomplished graduating from MIZZOU.

From that night on, I kept the ring in my custody, and wore it in my pocket, with the gold chain tied securely to my belt.  I am a MIZZOU grad, but I didn't earn my diploma the way Dad did, it was his to wear, so I didn't have the nerve to wear it on my finger.  But I kept it with me at all times, so I could have it there ready for him when he woke up....and have a part of him with me constantly, even in the moments that I had to step outside of the ICU room due to policy, etc.

As far as the drawing was concerned, the sharpee/highlighter process seemed to work as well as any, and I discovered that by mixing some blues and yellows, I scored a decent "green"---to me, a major break-through and technological achievement for highlighter illustration. I also got a few other sharpees, a few more highlighters, and some 'bristol board' paper during a quick trip for supplies with Mom....this way if I wouldn't have to keep mooching off of the nurses station supplies (because from experience working as an EMT myself, there never seems to be enough stuff like that there when you need it)...

 

Dad's service photo as a newly commissioned Ensign, in the United States Navy, after working his way through college at MIZZOU.  (disregard the strange blob under his left eye).

Dad's College Ring