“Do you know where you are right now?”
There is something in my throat, some kind of tube. I can hear a whir and click of machines. This is a hospital. I blink once.
“Okay, Diana, cough for me.”
The moment I try, that tube slips up and out, ridge by ridge, and my throat is raw and so so so dry—
I cough and cough and remember not being able to breathe. My eyes focus on writing on the plate-glass window of my room. The letters are in reverse, for whoever’s on the outside coming in, and I have to puzzle them out in the right direction.
COVID +
Someone is holding my hand, squeezing tight. It takes all my strength to turn my face.
He is dressed like he’s an astronaut, gowned and gloved, with a thick white mask covering his nose and mouth. Behind the plastic shield he wears, tears stream down his face. “You’re going to be okay,” Finn says, crying.
He is not supposed to be here.
He tells me that he begged a nurse to let him in, because even though I am in his hospital I am not his patient, and right now no visitors are allowed in the ICU. He says I gave everyone a hell of a scare. I’ve been on the ventilator for five days. He tells me that yesterday, when they dialed down the ventilator for a spontaneous breathing trial, my numbers on the gas looked good enough to extubate me.
None of this information fits into my brain.
Another nurse sticks her head into the room and taps her wrist—time’s up. Finn strokes my forehead. “I have to go now before someone gets in trouble,” he says.
“Wait.” My voice is a croak. I have so many questions but the most important one blooms. “Gabriel.”
Finn’s brows draw together. “Who?”
“In the water, with me,” I force out. “Did he … ?make it?” I pull air into my battered lungs; it feels like breathing broken glass.
“A lot of Covid patients experience delirium when they’re taken off the vent,” Finn says gently.
A lot of what?
“It’s normal to be confused when you’ve been sedated for so long,” he explains.
I’m not confused. I remember all of it—the current that swept me out to sea, the salt burning my throat, the moment I let go of Gabriel.
I clutch at the white sleeve of Finn’s doctor’s coat, and even that small motion is exhausting. “How did I get here?”
His eyes cloud. “Ambulance,” he murmurs. “When you passed out brushing your teeth I thought I—”
“No,” I interrupt. “How did I get back from the Galápagos?”
Finn blinks. “Diana,” he says, “you never went.”
TWO
TWELVE
Later, I would learn that when you want to take someone off a ventilator, you use the acronym MOVE to gauge readiness: mental status, oxygenation, ventilation, and expectoration. You want the blood vessels in the brain to be receiving and perfusing oxygen, so that the patient can process information and respond. You want the oxygen level to top 90 percent, and you want the patient to be able to overbreathe the ventilator. You have to make sure she can cough, so that she will not choke on her own spit when the tube is removed.
To determine this, a spontaneous breathing trial is done. First the patient is switched to pressure support mode, to see how much of a breath she is capable of taking. Then comes a spontaneous awakening trial, to see if the patient can wake up when the amount of sedatives being pumped into her veins is lessened. Finally, the pressure support is turned off to do a spontaneous breathing trial. If the patient can maintain low carbon dioxide levels, then she is ready for extubation.
This process is called a sedation vacation.
It is, according to my nurse, Syreta, the only vacation I’ve been on.
I am alone most of the time, but it seems there is always someone hovering outside my door, peering in. The next time Syreta comes in, I ask why, and she tells me that I’m a success story—and the staff has had precious few of them.
Syreta tells me that it’s normal to feel wrung out. I can’t sit up on my own. I am not allowed to eat or drink—I have a feeding tube down my nose, and will until I pass something called a swallow test. I am wearing a diaper. Yet none of this is as upsetting as the fact that everyone keeps telling me this is real: the moon-suited medical team, the wonkiness of my body, the television reports that schools and businesses are all closed and that thousands of people are dead.
Yesterday, I was on Isabela Island and I almost drowned.
But I’m the only person who believes that.