Coma

Buddha sleeps,
Family weeps.

T
h e phone ca ll from my father is something I will never
forget. He called me early on a Saturday morning. “Your
mother took a serious fall last night and is not good,” he said
in a serious, flat monotone, which was scary in its flat deliv-
ery. My father was usually an optimistic, cheerful man, and over the
years when he had called to deliver bad news, he usually did so with an
upbeat note in his voice. There was none of that now.
“It looks like a long road ahead,” he said.
It was such a matter-of-fact statement; I know he was just trying to
make the best of things, to take the burden of responsibility on himself
and not bother me with sharing that responsibility. I don’t think he had
fully realized what had happened; he was exhausted and still in a state
of shock. He described the accident, the ambulance ride to the hospital,
how she now lay unconscious in the intensive care unit. He told me
there was no need to come home: I had a life of my own to take care

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of, he said. He knew that I was going through a rough time with my
wife’s failing business and marital problems. Even so, it was my mother,
and it was my father too, and although I appreciated my father’s solici-
tude, I thought they could both use any support I could give them. I
quickly packed a bag and told my boys that their grandmother was sick
and needed my help. I told Belinda what had happened. There was no
“I’m sorry,” or “tell your father and sisters my thoughts are with them,”
just a stoney silence. It was sad, in many ways, because my mother and
Belinda had been friends. My mother had come to Manhattan to help
when Chas was born, because Belinda’s own mother had died of cancer
when Belinda was in college. When the boys were little, Belinda would
take them to Naples in the winter and stay with my mother when I was
too busy with work and couldn’t go, and my father was still working
in Buffalo, and the four of them would go to the beach, the pool, play
with Chas and Niall and just hang out. But the marital problems had
destroyed the relationship between my mother and Belinda as well.
I got in my car and drove the ten hours to Buffalo.
At the hospital, my father was right, there really wasn’t anything I
could do. My mother lay on her back in the bed, eyes closed, tubes and
wires connecting her to various monitors and machines. She was in a
deep coma and was outwardly unresponsive to any stimuli.
And yet, and yet….
I gently rubbed her arm and spoke softly to her, letting her know
I was there, her only son, her baby boy, in the hopes that maybe, just
maybe, some kernel of consciousness was aware of my presence and
would help alleviate her pain, help her heal. I loved her, I was there for
her, and I wanted her to get better.
Bernie Glassman, a well-known American Zen master who is Mat-
thiessen Roshi’s closest teacher, the one who gave Peter“transmission”
or certification to teach as a Zen Roshi, is a proponent of what he calls
“bearing witness.” The belief behind bearing witness is that by letting
go of fixed ideas, by bearing witness to whatever is taking place within
us and right before our eyes, we can heal ourselves and others and bring
peace to the world around us. I was at the hospital to bear witness.
As my father, sisters and I began our vigil at the hospital, there was
nothing we could do but wait. The neurosurgeon met with us in the
family meeting room down the hall and explained the facts: the MRI

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showed an area of severe damage in her frontal lobe, the images showed
an area of necrotic brain tissue, brain cells that had died from the impact
of the fall. The dead brain tissue was in an area that controlled language
and other higher functions. He could tell us that, if she lived, her speech
would be severely impaired, and she would have other impairments as
well, but he couldn’t say exactly what. The next twenty-four hours
would be crucial to her survival. The doctor had inserted a catheter to
drain excess fluid from her brain to relieve pressure in the cranial cavity,
but if her brain began to swell, much as an injured ankle balloons up,
then she would be in serious trouble. When the brain swells, unlike an
ankle, there is no place for the tissue to go; the resulting increased intra-
cranial pressure kills the brain, crushing crucial tissue and restricting
blood supply, which causes death in the patient. If the pressure in her
cranium began to rise, the surgeon explained, we had two choices: let
her die, or operate to remove the part of her brain that was already dead
to provide enough space for her brain to swell.
There was no way to know what was going to happen, he said, and
so no need to make a decision just yet. Some people’s brains swelled
more, some less. The nurses would keep monitoring the pressure
inside my mother’s skull—that was the function of one of the monitors
behind her bed. We should be thinking seriously about what decision
we would make, he said, because if the intracranial pressure rose, he
would need to get her quickly into surgery if we wanted her to live.
How does a family make a decision like that? My mother had
a living will and health care proxy, stating she wanted no artificial
life-sustaining measures in the event she became incapacitated with
no chance of recovery, and giving my father the legal authority to
make decisions about withholding artificial life support. But such
decisions are rarely so cut and dried, especially with brain injury.
How incapacitated would she be? What does “recover y” really
mean? What level of disability would be acceptable to a person? And
not just a hypothetical person, but my mother, the woman who had
given birth to me, raised me, held me when I cried as a child? What
level of disability would be acceptable to us as a family? What could
we handle, emotionally, physically, financially? The neurosurgeon
left us to our thoughts, and we hoped we would not be forced to
make the decision he described.

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I returned to my mother’s room and sat by her bedside, watching her

labored breathing, the bandages wrapped around her head, wondering
what she would want, asking myself how so senseless an accident could
have happened. She had always been an incredibly vibrant woman, full of
life and laughter. She had many close friends, had always been an ardent
sportswoman, had been active in the church and worked as a volunteer
for a number of different charities. She had owned her own business and
raised a family. Just the day before, Kristan told me, Kristan and mom
had played golf. The country was still reeling from the events of 9/11, so
Kristan was not very busy with her real estate business. She called my
mother that morning and suggested they play, since it was a gorgeous day.
Afterward Kristan, Mom, Dad and Kristan’s three-year-old daughter
Elizabeth had walked to a favorite Greek restaurant near Kristan’s house
for a late lunch. How could a woman have such a carefree day and a day
later be lying in a coma, unable to move, speak or smile?
On the night of the accident, my parents had been at a dinner party
in an unfamiliar house. As people were finishing their meals, she leaned
over to my father and told him she was going to the bathroom. It was
an old, rambling house, and no one will ever know exactly what hap-
pened next, but she went through the kitchen and into a back hallway,
where there were a number of doors. Apparently she had walked down
the dimly lit back hall, opened what she thought was the bathroom
door, probably looking for a light switch, and instead stepped into the
void. Where she had expected her foot to find a solid bathroom floor
in the dark, instead she found empty air, lost her balance and tumbled
headfirst down the basement steps, smashing her skull on the concrete
basement floor. A guest who was in the kitchen clearing her dishes
heard a loud sound, went into the back hallway and found my mother
crumpled at the foot of the basement stairs.
I grew up in old houses, and as I sat by her bedside I couldn’t help
but think that if the owners of that house had installed a simple dollar-
fifty latch hook on the basement door, my mother wouldn’t be lying
unconscious in front of me. My mother was not a big drinker, usually
having one glass of wine with dinner, so the fall couldn’t be blamed on
too much alcohol. She was relatively young, in good shape, no family
history of heart attacks or dizziness or any number of other conditions
that could cause a fall. It was a freak household accident, so senseless.

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We took turns sitting by her bed and then retiring to the family
waiting room for some rest. I wandered the halls of the hospital, find-
ing a small chapel on the first floor where I could pray in silence for her
recovery. Then I would come stand by her bed, hold her hand, or hold
my sisters’ hands, and we would cry, our tears falling silently on the
crumpled sheets covering our mother’s prostrate form.
Finally the thing we had dreaded happened. In the middle of the
night the swelling became more pronounced, and the attending nurses
called the neurosurgeon who rushed to the hospital and met with us in
a private room at four a.m., where we could make the decision we had
all hoped would never come. The doctor had a varnished box under his
arm. It contained his operating glasses and instruments, he explained,
and he never let anyone else keep them for him. He was ready.
The final decision was my father’s, of course, but we had always
been a close family, and as much as possible this would be a family
decision. “What would she be like?” we asked. “What would her
quality of life be like? Would she be able to speak? To walk? To care
for herself ?” We peppered the surgeon with questions, and as before
the doctor could give us no specific answers to those questions, only
saying he believed she would always have impairments and disabilities,
but with time and therapy she would be able to resume some activities
of daily living. However, there were no guarantees. Even with all the
advances in neurology and brain imaging and understanding how the
brain worked, no one could say with certainty which parts of her brain
had been damaged beyond repair and which hadn’t. No one could
say for sure what removing the part of her brain that had already died
would do to her. It was a part of the brain that controlled language,
memory and cognition, that much was certain, but the brain worked
in interconnected ways that still weren’t fully understood, and parts of
her brain that survived might take over functions that had been previ-
ously controlled by the now-dead tissue. It was a relatively new area of
neurology known as neuroplasticity.
My mother had loved life; we all felt certain she would want to live,
given the chance, but what kind of life would she want to live? She had
been an expert skier, sailor and tennis player, but degenerative arthritis
had forced her to have both knees replaced seven years before and pre-
vented her from ever skiing or playing tennis again, so she had taken up

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golf. She had been diagnosed with a rare sinus cancer in 1999 and had
suffered through chemo, radiation and a brutal operation to remove a
tumor that left her face partly disfigured, even with reconstructive plas-
tic surgery. Told she only had a forty percent chance of surviving, she
had beaten the odds, and even though she had her days of tears, mostly
she kept smiling and laughing throughout the entire ordeal.
As we stood there with the neurosurgeon I finally asked the one
question that I thought would be most important to her: “Will she
know her grandchildren? Will they be able to sit on her knee and hug
their grandma and have her hug them back? Will she be able to play
games with them, however basic those games might be? Read to them,
even if it’s with impaired speech?” The neurosurgeon said, yes, he
believed that she would still be herself, would still have her own per-
sonality, would still recognize people and be able to take part in the joys
of daily living, albeit with disabilities. So we said all right, do the opera-
tion, we can’t just let her die. She loved life, she would want to live.
In the months that followed I made the trip back and forth to Buf-
falo many times, spending a week at my mother’s side as she still lay in
a coma after the operation, then returning to my own family and work.
I would meditate silently by the side of her bed, praying for her recov-
ery. I would go down to the chapel and pray some more. I went to our
family church, Westminster Presbyterian, where my parents had been
married, where both my sisters and I had been married, where my aunt
and uncle were married, where my grandparent’s funerals had been
held. I was amazed to discover that this bastion of WASP conservatism
was holding weekly Zen meditation sessions in the basement meeting
room, and I would sometimes join them. The minister, Tom Yorty, a
friend of my mother, frequently stopped by her bed in the hospital.
As I silently sat with her for days on end in the intensive care unit,
watching her hover in a state somewhere between life and death, con-
nected to all the life support tubes and machines, I would meditate in a
chair, back straight, hands in my lap, concentrating on my breath, and I
began to get a sense of how precious my mother’s life was, how precious
she was. At times I almost felt guilty, because instead of feeling the
immense grief I usually felt, I would feel a simple joy just being in her
presence, being in the presence of a sleeping buddha, and tears of joy
would mix with the tears of sorrow staining my mother’s sheets.

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