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Interview 04

Age at interview: 58
Brief Outline: In October 2004, her son had a motorbike accident and was admitted to ICU. He had a serious head injury and broken jaw.
Background: Nurse, married with three adult children. Ethnic background/nationality: White British.

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In October 2004, her son had a motorbike accident and was admitted to ICU. He had a serious head injury and broken jaw. In total he spent five weeks in ICU and was later transferred to a rehabilitation hospital for three weeks. At home he was looked after by his parents and is making a good recovery. 

During the early part of her son's stay in ICU, when the outcome was uncertain, she found it helpful to talk to the hospital chaplain. She and her husband believed from the moment they saw their son that he would survive and they focussed on what was happening there and then. Although she was happy with the overall care her son received, she was disappointed with the approach of two doctors who didn't believe her son would recover from his head injury. 

At the time of interview she had had some disturbing dreams, which she felt could have been the result of buried emotions surrounding the events of her son's accident. She felt that her son was making a miraculous recovery, and she had returned to part-time work and study.
 
 
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Even though medical staff were treating their critically ill son, he looked comfortable when they...

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Then I was allowed to come and see our son. People were doing things to him. And he had no sign of any injury but I could only see him from the chest up. But he just looked like he was sleeping. He just looked utterly comfortable and fast asleep. And his motorcycle gear had been cut off him and it was in a pile by the door and his boots were there, and his helmet and everything. And then I went back into the little room and the policeman kept making me cups of tea. I think he made me about three altogether [laughs]. He was very friendly, very supportive. 

When I very first saw our son, I had a feeling that he would be all right when I saw him. And funny enough when I went in with my husband and we saw him again, after my husband had seen him, we came out together and he said, 'I think he'll be alright.' And I said, 'Yes, I got that feeling too, I think he will.' When I went in to see him, I never sensed, but I could tell by looking at him that he, you get a feel for some things. When I was working on the Intensive Care years ago I was working on it for several weeks when all of a sudden I got to the stage where I could tell whether somebody was really ill or not. If, and I don't know what it is, and I don't know how it comes about, maybe because you're doing so many checks on the patients all the time, you suddenly get to the stage where you are connected to the point where you can look at somebody and you know whether they're ill or not. When I looked at our son when he was being attended to in the Emergency Room I got the feeling that he would be all right. He looked all right. He was all of a piece. There was something, and my husband had exactly the same kind of feeling. He shared it with me even though I hadn't said anything to him. I didn't say, 'I think he'll be okay.' That came straight from my husband as soon as he saw him. And I said to him then, 'Yes, I think he will be too.' And as it turns out, we were right. 

 
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In the early stages no one could give her information or hope on whether her son would be brain...

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They didn't know what the outcome would be. We had no idea at the beginning, whether he would come off the ventilator, whether, what the outcome would be. And actually at that point, we weren't even thinking about outcomes. We were simply, we shutdown to the point where we were thinking of exactly what was happening right in front of us, that seemed to be the best way to cope. And so that's what we all did automatically, it's not something we discussed. 

I think the doctors were very hesitant. They were very honest. They were very clear about what they were reading on the CT scans. They were liaising with the City hospital. I believe there was an expert there who was advising them on how they should be coping with our son, that was my understanding of what was happening. And that they were constantly talking to the City hospital, sharing the expertise. 

And they obviously could not be drawn and we wouldn't have wanted them to be on how he was going to come out of this, it was far too soon. So we had no idea, incredibly stressful really. 

And you mentioned that, at the time, were you just dealing with what was in front of you? 

Yes, very much so. And when he was there, the fact that he was there, and not knowing whether he would come off the ventilator, we didn't even think about it. But you know, when it happens then you face it. And when his tracheostomy came out, would he speak again?

 
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As a nurse and mother she refused to believe doctors who were telling her that her son would be...

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We noticed very early on that he was responding, he was appropriately responding with a squeeze of a hand or an expression on his face. The staff at first, were disinclined to believe that this was happening. They were very kind but they also were looking at the results of the CT scans that they could see, they were interpreting what they were seeing. And from the results of the CT scan, they weren't sure that we could possibly be seeing what we were seeing. If you love somebody and you know them very well, you can often pick up things that other people who don't know them wouldn't be aware off. And there might be a flicker of amusement on my son's face or he might you know, frown or' and it would be entirely appropriate to the situation that's going on around him. 

And I think they were... the staff were fantastically supportive. But there were two doctors, there was a young doctor on night duty in the early days, and I was sitting by his bed and all of a sudden she came out of the nursing station and she said to me, I have to tell you I'm a senior doctor. I've had a lot experience and your son is very severely brain injured, and you need to take this on board. Basically, those were her words. And I can remember saying to her, 'Yes, I know, I know he's badly hurt but it's too soon', because she was making the step of trying to encourage me to accept that this had happened. And I don't remember whether she was trying to' I don't know what she was trying to do really. I hadn't asked for the information and she kept trying to put over her point and my reply was always, 'Yes, I understand exactly what you're saying but it's too soon'. Obviously I did because I'm a registered nurse. 

But it was too soon. And she kept telling me and I just kept saying it's too soon.

I think that it's inappropriate for people to try and assume that they know how people are going to come out of something like a head injury because what you've got is an individual and they will come out in their own individual way when they're ready for it. And you can't' I don't think enough is known about head injuries. I know my son was severely injured by the accident but I honestly don't believe that enough is known for people to be able to stretch their professionalism to the point where they need to share their long term predictions' I mean it's too soon, you can't share that kind of news in an intensive care situation. Time itself heals an enormous amount. And at the same time allows you to take on board what's happened. You can't present people with that kind of information at that time, and' those were the only two doctors who did that. There were many other doctors, none of whom attempted to do that. 

They would, as much as they would say we don't know what's going to happen here. Yes he is severely injured, you know, we can see that. We can see what we're looking at. We do not know how he's going to come out of this. And that's absolutely fine. That's acceptable, we don't want predictions. It's too soon. 

 
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Other people's everyday concerns felt minor and trivial compared to her own anxieties about her...

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I remember I went into a shoe shop when he was still in Intensive Care and there was a young girl there and she couldn't decide between, she had two pairs of pink shoes, she couldn't decide between [laughs] and she kept going to her friends and asking which pair she should buy. And I can remember thinking, 'Oh my goodness, are people really tied up with styles'' and she turned to me and she said, 'Which one would you choose?' So I said, 'What are you going to use them for?' You know, 'Where are you going to wear them?' But at the same time, it's like you're living on a different planet because, you know, right at that stage we had no idea what the outcome was and we could still at that point have lost him, and so that is absolutely devastating. You know, that really, you just feel like you're crying on the inside the whole time. It's searing. And then you're faced with other people's, what they consider to be a problem, sort of everyday normal life, so you know, there's that huge divide.

 
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She found it extremely traumatic when someone died and difficult to be supportive to others when...

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When you're in the intensive care, you are very much aware of what's going on around you as well because all you're doing is sitting in a chair. And I was talking to my son, believing that he could hear me, that this would be a positive thing to do. But when you're in the relatives' room, you come into contact with other families. And that can be very traumatic. There were two young victims of road traffic accidents, both of whom passed away. And there are only curtains between the beds, in the main ward, I think I'm right in saying there were nine beds in the main ward. And there was one time when one young girl came in and her whole family were devastated, she was part of a traffic accident and a few days later she passed away. And so whenever you went out to the relatives' room and walked down the corridor, there were all of her relatives, they were obviously a very close family. That was very traumatic. You know, so you're trying to support each other as well as having your own relative to support. 

 
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She was extremely disappointed in two doctors who wouldn't believe her when she said her son had...

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We noticed very early on that he was responding, he was appropriately responding with a squeeze of a hand or an expression on his face. The staff at first, were disinclined to believe that this was happening. They were very kind but they also were looking at the results of the CT scans that they could see, they were interpreting what they were seeing. And from the results of the CT scan, they weren't sure that we couldn't possibly be seeing what we were seeing. If you love somebody and you know them very well, you can often pick up things that other people who don't know them wouldn't be aware off. And there might be a flicker of amusement on my son's face or he might you know, frown or' and it would be entirely appropriate to the situation that's going on around him. 

And I think the staff were fantastically supportive. But there were two doctors, there was a young doctor on night duty in the early days, and I was sitting by his bed and all of a sudden she came out of the nursing station and she said to me, I have to tell you I'm a senior doctor. I've had a lot experience and your son is very severely brain injured, and you need to take this on board. Basically, those were her words. And I can remember saying to her, 'Yes, I know, I know he's badly hurt but it's too soon', because she was making the step of trying to encourage me to accept that this had happened. And I don't remember whether she was trying to' I don't know what she was trying to do really. I hadn't asked for the information and she kept trying to put it over her point and my reply was always, 'Yes, I understand exactly what you're saying but it's too soon'. Obviously I did because I'm a registered nurse. 

Exactly the same thing happened with another doctor after my son had had his operation.... And when he came back they stopped all sedatives so he'd had a fortnight of complete sedation and then nothing. And so he obviously started to come out of it and was responding and one eye was opening. And at that time we thought he was seeing out of that eye and' therefore we could see responses in him, we were communicating with him. He had a tracheostomy so he couldn't talk. But we were clearly communicating with him. 

Then my son went down to have the peg put into his stomach. And in the afternoon this other doctor came on duty, a senior older doctor, and he walked into the room where my son was. My son had had a sedative and he had a local anaesthetic to have the tube put in. And the doctor said to me, 'You do realise that your son will probably not' this is how your son is going to be.' Obviously he was flat out because he'd had a sedative. I said to the doctor, 'No, my son is responding'. 'No, no, no', he said, 'Your son's not responding.' So I said, 'Well the nurses are aware that he's responsive'. So he said, 'No, no, no'. He said, 'It's typical of parents at this stage to feel that they can see responses in their relatives'. But he said to me, 'It's a bit like young parents with their first baby, when they think they see a smile and actually it's wind, it's not a smile, it's not a response'. And he said, 'This is what you're doing at the moment, you're reading what you want to see into the situation. He said, 'It will be easier for your son because he will be like this. So he probably won't be aware of, you know, what's happened, it could be much more difficult for you'. And by this time I was steering this doctor out of the room because you know, obviously my son, even though he was sedated, he could still be hearing this. And I was feeling a bit frustrated and irritated that I couldn't get over to this man that my son was responding. 

Then I took the doctor outside the room and we were talking in the ward, I actually got a bit upset beca
 
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She felt it was too soon to tell whether her son would be brain damaged after an accident and she...

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I think the reason I'm talking about this is that I think that it's inappropriate for people to try and assume that they know how people are going to come out of something like a head injury because what you've got is an individual and they will come out in their own individual way when they're ready for it. And you can't' I don't think enough is known about head injuries. I know my son was severely injured by the accident but I honestly don't believe that enough is known for people to be able to stretch their professionalism to the point where they need to share their long term predictions. I mean it's too soon, you can't share that kind of news in an intensive care situation. Time itself heals an enormous amount. And at the same time allows you to take on board what's happened. You can't present people with that kind of information at that time, and' those were the only two doctors who did that. There were many other doctors, none of whom attempted to do that. 

They would, as much as they would say we don't know what's going to happen here. Yes he is severely injured, you know, we can see that. We can see what we're looking at. We do not know how he's going to come out of this. And that's absolutely fine. That's acceptable, we don't want predictions. It's too soon. 

So that happened and actually the staff were very angry with the doctor for doing this, apparently he's done it to other people as well. And I was given the opportunity many months later of actually talking to him with another senior doctor who was there and also a senior sister. I was actually asked to come into the hospital and go over it again. But I still don't think, I mean I've never had to go over anything like that before so I still don't think I knew how to handle that situation properly. I'm not sure whether it was talked through. But I do feel that awareness was raised amongst the senior staff that this was happening, and that for me it was inappropriate to be approached in such a manner whilst my son was in the intensive care unit in the early weeks of his accident. Obviously it's different for other illnesses or you know, if you break a leg, you know it's going to be so many weeks for recovery but for a head injury, I think you need to be very careful about long term predictions because you see the other thing is that I'd' first of all I didn't feel that I could turn to this doctor anymore.

I would have preferred them not to have approached me at all in that way. I think it's inappropriate. Unless you're actually asked by somebody, directly, what you think the outcome is, and even then I think you need to be measured in your response, you know, it really isn't good enough to feel that you need to have to pass on bad news and I don't know what the reason would be for it. Because really there's no place with a head injury to a young person to move things on as quickly as possible. There really isn't. Now it may be appropriate for people who are perhaps much older and dying of cancer or other illnesses but it's too soon for a head injury. It wasn't necessary and I would have preferred it not to have happened. I didn't ask for their input, but both times I was approached, all the rest of the time all the other doctors were there and we were able to ask what we wanted to, and when any results came back, and then they were, 'We've got these, come let's talk about it.' So they were utterly supportive without pushing themselves. So I don't know what it is that causes some people to feel that they need to move people on. It's too soon.

 
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Her son had to have his own room because he had MRSA but she felt he was in danger of injuring...

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When he stood up, there was a rush of blood from his head which caused him to faint, every time he stood up in the intensive care unit. So he had to be very careful about that. His memory at that time wasn't operating at all so he wasn't able to remember that he shouldn't be standing up on his own. And the healthcare assistant basically said to him to do as much as possible for himself! 

So twice on the first day of being admitted to the single room, he fell over. Once I was in the door way so I wasn't able to get to him first of all and then I wasn't aware that he was going to be doing this. And then somebody visited him in the evening and when I was saying goodbye to his friend at the door, my son then tried to put himself back into bed because you know, he had to do as much stuff for himself [laughs]. And of course, as soon as he gets up he collapses because the blood' I can remember sitting in the main hall of the hospital that night because I'd been with him all day and I can remember, it was late at night, and I can just remember just bursting into tears and saying to my husband, 'I can't be here twenty four hours and I can't keep him safe'. And knowing that we were going to go home and he could fall, so that was actually quite traumatic. 

It was circumstances, you know, and I'm quite sure if he hadn't had the MRSA, he would've been in with everybody else, and other people would've kept an eye on him. It's unfortunate that he contracted that. And you know, I mean, he'd gone to a ward where they had orthopaedic patients coming in, so the last thing they needed was somebody with MRSA coming in to their ward. So you know, you can understand the conflicts that were there. But it was a horrible feeling because I knew that he wanted to do as much for himself as he could. He been told to get on with it and I knew he wasn't safe. And I also knew that if he fell over and banged his head again, there is that secondary impact where it's so much worse. And what frightened me was that if he banged his head, the swelling would be out of control. It would start a chain of events, basically he would kill himself because you don't have to hit your head very hard the second time for it... so that that was quite frightening. I didn't like that at all. 

And how long was he there for? 

He was there for about five days.

 
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Her son walked for the first time since his accident when he was in a rehabilitation unit and she...

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My son was met by many people, including a physiotherapist who basically said because my son, by that time he was standing all right, so she said, 'Right', she said, 'We're going to take you down the hall'. And he stood up and with her on one side and her assistant on the other, for the very first time he actually walked since his accident. 

And he walked down the hall to the nurses' station and they'd got Christmas decorations and he's quite tall and his head kept bumping the Christmas tinsel as he walked down the hall. But it was the first time he'd actually walked since his accident and that physiotherapist got him back onto his feet and got him walking. She was superb, absolutely superb. She was just what he needed to get him started. And he developed a deep respect for her as well and he is the kind of person who will work very hard to make things happen. So he was also able to do what she said because first of all he needed help to go everywhere and then he just needed one person to help him. And then he was able to walk using the wooden rails that they've got in the corridors.

 
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Her son is now driving again and she is looking forward to the time he will be completely...

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I don't envisage that I will always be at this stage. I mean he's so much more independent now, in his thoughts, feelings, you know, driving. It's all coming back together. And really I hope to get to the same stage I was at' it's kind of like accompanying somebody' when you have a child, you accompany them through their childhood and when something like this happens it's like going back to square one and doing it all again. 

So I think that I'm looking forward to the stage and I know that it is happening because I can see that it's happening, where he will be independent again and that is the ultimate goal. And I don't envisage that he will need me. And that will be tremendous when that happens. And so, you know, we've been utterly blessed, utterly blessed, with the way things have happened because he was very severely injured right at the beginning. And he has really come through this in a miraculous way. 

 
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After her son's accident, she found it difficult to read, watch certain television programmes and...

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I found, even, I couldn't read. I love reading but I couldn't get past the first paragraph of anything. I couldn't watch television. I have always kept up to date with the news, that's one thing I like to do. I was totally out of touch with the news. And even now I can't watch certain things on television. If there's a violent programme or something which causes me to feel emotional inside, I can't watch it. It's stretching me too far, I'm already stretched. I don't have that give. It's coming back, it's much better than it was. If I'm driving and I can hear or see an ambulance going, I used to burst into tears at the beginning, that doesn't happen anymore. I still say a little prayer for whoever it is that they are going out to or they are taking. So I think it takes a long time for things to settle afterwards. 

You are changed. I've had post-traumatic stress, I know what it feels like and I know that, whilst my experience was individual to me, was individual to me, it can change the way you are and the way you react for a time, until you come back into yourself. So I feel that's what I've been doing really.

 
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She wanted to see how her son would progress without outside influences but also wondered if it...

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I don't think I would want to belong to, the support group that we have been offered, there is one specifically for head injuries and there's an organisation as well and I've never felt that I wanted to belong to that because I feel that my son is evolving out of this and I don't want to feel that I know where he should be or I know what's coming. I want to remain supporting him in terms of where he's actually at. And I feel that if I belong to something like that then perhaps I would be closing a few doors. Does that make sense? I want to listen to him, to how he feels, to how he's coming out of it. So I haven't actually joined anything like that, not yet. But again, you know, maybe in time, but, I keep using this expression, 'it's too soon' [laughs].

It's too soon. 

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