An Extra Hour's Breathing

Around 11pm tonight, two aides hoyered Brooke from his wheelchair into bed, did a last cleanup and cath, brushed his teeth, put on his hand splints and boots that prevent foot drop, and covered him with the usual sheet. They turned the CD player on to the same Julian Bream recording of Bach that he has listened to practically every night (indeed, all night, since the player is set to repeat) for the past eight months (though he listens to lots of other Bach and other guitar music and other remarkable recordings during the day, he loves this recording for sleeping). He’d already had his evening meds, and several hours earlier he had odysseused the sleeping pill: Take it out of the cupful of pills, he’d said, but since he knew he could always ask for it again later on, he’d added, and throw it away. (In a hospital, pills don’t just get thrown away, and especially not narcotics; there’s paperwork involved when one isn’t taken to ensure that it wasn’t diverted somewhere, but this was cheerfully done.) As he settled back onto the pillow, eyes closing in evident contentment, he murmured happily, I made a breakthrough. I made a breakthrough, barely finishing the second phrase before he was asleep.
It wasn’t just declining the sleeping pill to keep from being fuzzy in the morning. It was the extra breathing. He’d already done a morning session off the vent of 2 hours 10 minutes, then a late afternoon session of another hour and 20 minutes. That’s already a respectable performance. But this evening, perhaps partly because one of the respiratory therapists who is particularly enthusiastic in pushing forward happened to be on duty, Brooke volunteered to do a little more time off the vent. Right after dinner, he said, so we had a wonderful chile verde made by a friend, washed down with a bottle of beer, and a lovely heirloom tomato grown in our own garden, thanks to sets planted by a neighbor, and then brownies baked by other friends earlier that day, and we felt rather loved. Then Brooke settled into the third trach mask of the day—15 minutes, then half an hour, then eventually a whole entire hour. According to the numbers—the end tidals, the SATs, the volumes—he wasn’t even tired and his breathing wasn’t labored a bit, but as you know he did settle onto the pillow and even without the sleeping pill was almost instantly asleep. I made a breakthrough. I made a breakthrough, he said, and, indeed, he had. An extra hour’s breathing. After the hard days in the last couple of weeks, this looked like a year in bliss.