“She's alive, Mrs. Clarke. She's a strong girl. She sustained a tremendous blow, and an ugly injury. A lot of people wouldn't have made it this far. But she has, and we hope that's a good sign. But there's a long way to go right now.
“What she has sustained are essentially two kinds of injuries, each with its own particular complications. Her first injury occurred at the moment of impact. Her brain was decelerated against the skull, and to put it simply, pretty badly shaken around. It may well have been rotated, and in the process, nerve fibers probably got stretched, and arteries and veins would have gotten torn. This can cause a tremendous amount of damage.
“Her second injury actually appears to be more frightening than the first, but may not be. She has an open wound where the skull was cut through, and the bone of the skull had been broken. Her brain is actually exposed right now, in that area, probably where she was struck by some sharp piece of steel in the car just after the impact.” Page made a horrifying little sound as she listened, and clutched Trygve's hand without thinking. She felt ill thinking of what they had just said, but she was willing herself not to faint or throw up. She knew she had to absorb what they were saying.
“There's a good possibility …” the chief surgeon went on relentlessly. He knew how unpleasant this was for them, but he also knew that he had to explain it. They had a right to know what had happened to their daughter. He was assuming that Trygve was Allyson's father. “There's a good chance that the area away from the open wound is actually undamaged. We often see very minor long-term disability from these open head wounds. It's the first injury that has us worried. And of course, the obvious complications from both situations. She's lost a fair amount of blood, and her blood pressure would have dropped severely anyway from the trauma. She's badly weakened by the blood loss. In addition, there's a loss of oxygen to the brain. How much we don't know, but the damage could be fairly catastrophic … or very slight. We just don't know yet. Right now, we need to get in there and help her. We need to lift the bone that was depressed in the fracture, to relieve some of the pressure. We need to address the wound. And there's some additional repair work we're going to have to do around the eye sockets. She sustained a tremendous blow, which could ultimately blind her.
“We have other concerns too. Infection, of course, and she's having quite a bit of trouble with her breathing. That's to be expected, in this type of injury, but again it could cause some catastrophic complications. We're keeping the breathing tube through her trachea that the paramedics put in and we've had her on a respirator since she got here. We've already done a CT scan on her which gave us some very important information.” He looked at Page, who sat staring at him, and for a moment he wondered if she had understood him. She looked totally dazed, and the girl's father seemed no better. He decided to try talking to him, since the girl's mother seemed so unable to absorb it.
“Have I made all of this clear, Mr. Clarke?” he asked hopefully, sounding frighteningly calm, and almost without emotion.
“I'm not Mr. Clarke,” Trygve croaked, as overwhelmed as Page by what he had told them. “I'm just a friend.”
“Oh.” The chief surgeon looked disappointed. “I see. Mrs. Clarke? Do you understand me?”
“I'm not sure. You're telling me that she has two major injuries, basically a shaking of the brain, and an open wound which results from a fracture of her skull. And as a result of the damage, she may die, or she may have permanent brain injury …and she may be blind … is that about it?” she asked with tears welling up in her eyes. “Did I understand it?”
“More or less. Our next concern after the surgery will be a possibility of what we call 'third' injury. There could have been second injuries as well, but she avoided them by wearing her seat belt. In third injuries, we look for acute swelling of the brain, blood clots, and severe bruising. This could be a very serious problem. It's not likely to occur until at least twenty-four hours after the injury, so it's a little difficult to predict at this moment.”
Page asked the one thing she'd wanted to ask ever since she'd heard, but she was also afraid to hear the answer. “Is there any chance she'll ever be okay again … I mean normal? Is that possible, given all that's happened?”
“Possible, as long as we all understand that there are degrees of normal. Her motor skills could be affected, for a time, or even indefinitely. They could be affected in minor ways, or very major ones. Her reasoning processes can be affected, her personality could change. But on the whole, yes, if she is very, very lucky, and blessed with a small miracle, she could be normal.” But he didn't look to Page as though he thought it likely.