Chapter Fifty-Six
Tony sat across from Kevin with a handful of thick papers in his fist. He rhythmically tapped the papers on one knee and regarded Kevin with a stern gaze. "I want to review this whole ECT process from start to finish again before I agree to the procedure," he stated firmly. "As Lucky's legal guardian, I had to go to court to get permission to allow you to do this. Don't let me feel like this is a mistake."
Kevin nodded sympathetically. "I understand your concerns. Did you review the copies of the literature that I gave you to read?"
"Yes," said Tony, "But I want to hear it directly from you. You have to realize how hard it is for me to allow this with neurology as my specialty. I help people with brain trauma, not cause it. But, I'm willing to allow Lucky to have this procedure if it will save him and help him to recapture his life. I guess I'm looking for some reassurances. I'm especially concerning the potential for memory loss."
"Let's walk through the process, and I can address your concerns and answer any questions that you have."
Tony nodded with a tight expression, and Kevin continued. "We perform ECT in an operating room in case there are complications, so he'll be in a setting that's equipped to handle any potential cardiac or respiratory distress."
"That's good planning," said Tony with approval.
"First, we'll inject an anesthetic into his IV. I'm recommending propofol for its success in minimizing seizure times in adolescents. It also minimizes any post-procedural nausea. Then, succinylocholine will be given for muscle relaxation. Venilatory assistance will be provided, and his EKG, blood pressure and pulse rate will be monitored throughout the procedure."
"What about an EEG?" interrupted Tony.
"We'll monitor the seizure via a blood pressure cuff," explained Kevin.
"I'd be more comfortable if he had an EEG during the procedure, at least for the first session or two until we know how he'll react," stated Tony.
Kevin nodded and made a notation on a pad of paper. "We can arrange for that. The machine that we use at General Hospital is state of the art. It uses a brief pulse stimulus rather than the older sine wave stimulus. We'll perform a unilateral ECT on his nondominate side. This should assist in preventing memory deficits and result in a shorter confusional period. We'll place electrodes frontotemporally and on the ipsilateral side and induce the seizure. When seizure activity ceases and his vitals return to normal, he'll be moved to his regular room, where his vitals will be monitored periodically."
"And how many sessions per week are you recommending?" asked Tony.
"The standard is three procedures per week," replied Kevin. "We'll administer three per week until he lifts out of his catatonic state. So, he will probably need between three and nine sessions over a period of one to three weeks. After his ECT is finished, we'll maintain him on antidepressants."
"The mortality rate for the procedure is fairly low," remarked Tony.
"Yes, three out of ten thousand,," replied Kevin.
Tony sighed. "I just hope that after this I don't have to be Lucky's neurologist as well as his uncle."
~*~*~*~
Next morning…
"He needs to be transported down to OR2," the nurse directed the two orderlies. "Be careful, he's still connected to an IV and is catheterized."
The orderlies grabbed hold of Lucky and said, "One, two, three, lift." They easily transferred Lucky from his bed to the gurney, covered him with a blanket and strapped him down. "This one isn't too bad," one orderly commented. "Remember that heavy guy yesterday? He must have weighed 300 pounds."
The nurse adjusted the IV and catheter bags next to Lucky. "Okay, guys," she said. "Be nice to my favorite patient." She ran a hand over Lucky's hair and said kindly, "We'll see you when you get back."
~*~*~*~
Lucky was wheeled into OR2. He lay motionless on the gurney with his eyes openj, staring blankly. He woke every morning with the rising of the sun, his eyes opening but not registering the life around him, and this morning was no exception. The orderlies transferred him from the gurney to the metal table, and the attending nurse hung his IV bag on a pole. A technician applied the EEG electrodes to his skull, and the ECT electrodes were applied as well. He was hooked up to an EKG and a blood pressure cuff was wrapped around his left leg. A pulsimeter measured his pulse rate, and all systems were checked.
Tony and Monica were watching at a distance, and Monica reached over to pat Tony on the back. Tony's face betrayed the extreme tension that he felt, and Monica was subdued. "We perform medical procedures every day," said Monica, "But it's awfully hard to see our family and friends in trouble."
Tony rubbed his nose and shook his head. "That's an understatement."
The anesthesiologist injected medication into Lucky's IV, and after several seconds, Lucky's eyelids flickered and closed. A tube was inserted into his throat, with ventilation by a positive pressure bag using 100 percent oxygen. The anesthesiologist injected the muscle paralyzer into the IV. After a few minutes, he nodded to Kevin who flipped switches on the machine. Lucky immediately went into a seizure, and the EEG technician confirmed, "He's in a bilateral seizure." The muscle paralyzers injected into his IV prevented Lucky from thrashing wildly. Kevin and several technicians monitored their watches to count the number of seconds that Lucky seized. Kevin nodded. "Fifty seconds," he stated. The ECT electrodes were removed, and Lucky's vitals were monitored.
Tony looked down at his hands and discovered that he'd been digging his fingernails into his palms with the evidence of deep red semicircular marks pressed into his flesh.
~*~*~*~
One week later…
Emily was seated next to Lucky's bed. She stroked his right arm with tentative fingertips.
"Hey, Lucky. My mom finally said I could visit you. It took a lot of fast talking. I really wanted to see you. I'm sorry I couldn't come earlier."
She alternately roughed and smoothed Lucky's fine blond arm hair as she spoke. "You look like you're losing weight again, Lucky. Won't you please wake up so we can go back to our lives?"
Emily rose from her seat and caressed his cheek. "I love you, and I miss you. I haven't had a marathon two-hour phone call with you in weeks. I'm in withdrawal."
Emily bent over and lightly kissed Lucky's lips and laid her hand lightly on his chest. "Wake up handsome sleeping prince," she said in a teary voice with sad eyes. "I know it's not my fault, but I feel responsible, you know. I should have listened to you when you called me. I was in too much of a hurry to go shopping." A few tears escaped her eyes as she spoke, and she fingered the two silver necklaces that she wore, running her finger along the jagged cut edge that ran the length of the one heart.
"I've worn the necklace you gave me for Christmas every single day." She placed a hand over the small ruby heart that nestled on her chest. "I bought you something for good luck and so you know that you have my heart."
Emily gently raised Lucky's head and placed the silver necklace around his neck. "This is half a heart. It matches the heart on my necklace." Emily took Lucky's pendant and joined it to the pendant hanging from her necklace. "See? You place the two together, and you have one heart."
Emily reached over to Lucky's nightstand and picked up one of five golf balls lined up in front of his flowers. "I see that grandfather has been here," she chuckled. "He's an old softie. He'd never admit that he's been visiting you You know that you're going to have to play golf with him, so don't try to hide, Lucky. You can't stay in bed forever, sooner or later you'll have to face Edward Quartermaine."
~*~*~*~
Kevin Collins leaned against the nurse's station. "Lucky Spencer, the patient in 2B, had his fourth ECT session this morning. Have you noticed any differences in his behavior today?" One nurse spoke up, "When I changed his IV earlier, I thought he was frowning slightly. His face is usually rather stony in expression." Another nurse agreed. "His legs aren't as rigid as they have been. His muscles seem to be relaxing."
Kevin nodded. "He may be waking up in the next day or two. Have him transferred to a locked unit this evening. His behavior upon waking may be unpredictable. Page me when he wakes. Call me immediately if he escalates and avoid forcible restraint. We don't want to traumatize him any more than he's already endured. Also, I don't want any large males on his case - only females and slightly built men. Do you understand?"
The nurse who was making notations nodded and said, "Yes, Dr. Collins."
~*~*~*~
Tony answered the phone on the fifth ring. "Hello?"
"Dr. Jones, it's Nikolas Cassadine. May I speak to Lucky please?"
Tony ran a hand over his tense neck. "Nikolas. Lucky isn't here. When's the last time you spoke to him?"
"The day before Christmas Eve," replied Nikolas.
"Hmm," said Tony. "Nikolas, are you in the country or are you on the Eddie Maine tour?"
"I'm in England right now," explained Nikolas. "We're starting a new European tour. Dr. Jones, you're making me nervous. Is something wrong with my brother?"
"Nikolas, I would have called you earlier, but I didn't have your phone number. I looked for it in Lucky's room but couldn't find it. I'm sorry. Lucky had a breakdown on Christmas Eve, and he's still in the hospital. He's receiving treatment, and we hope that he'll be better soon."
"What? Dr. Jones, what's going on, how did this happen? Do I need to come back to Port Charles?"
"Nikolas, Lucky was struggling with depression and flashbacks from the time he was imprisoned. He received several bad emotional shocks and tried to commit suicide. He's catatonic right now, which means he's basically retreated into himself. He's receiving therapy, and we think he'll be back with us within the next few days."
"What do you mean by 'shocks,' Dr Jones? I need to know what's going on with my brother," Nikolas insisted.
"Nikolas, you can call me Tony. And what I mean by shocks is that Lucky experienced a bad flashback when he tried to visit his father in prison. It reminded him of his own imprisonment. And, he read a note sent by your mother, which was very upsetting."
"What did my mother write?" Nikolas asked with dread.
"She stated that she wouldn't allow Lulu to visit and that…well, she suggested…I don't know how to put this."
"Just spell it out, Tony. I can take it. I've been on the wrong side of my mother's affections before. Just tell me."
"She knew that he tried to kill himself before with a gun, and she sent him a gift certificate to a shooting range, implying that…well, that he should kill himself. He tried soon after reading the note."
"Oh, god…oh god," Nikolas said softly. "I had no idea she was capable of something like that. Oh, man, I didn't know…"
"Nikolas, there is one other thing. Bobbie and I have filed for custody of Lulu. We expect it to come through any day now. We have you and Lucky down for liberal visitation rights. Bobbie and I are remarrying, and Lulu will live with both Lucky and my son in our home. But right now, we have to concentrate on making Lucky well so he can come home."
"Tony, I'm going to wrap up some business deals and hand them off to my assistant. I'll be back in Port Charles within three days. I need to be here. I'll call you when I arrive."
"Okay, Nikolas. Lucky will be glad his brother is nearby. I look forward to talking to you again. Give me your cell phone number so I can call you if there's any news about Lucky."
~*~*~*~
Bobbie shivered as she glanced around the dark, drab gray visitation room. No wonder Lucky couldn't handle coming here, she thought to herself. This is the pits. She looked up brightly when her brother entered the visitation area on the other side of the glass and metal mesh barrier, but her heart sank quickly when she took in Luke's appearance. He was much thinner than she'd remembered and seemed to have aged
Luke sat opposite of Bobbie, and his bright blue eyes met her warm brown eyes. Well, he still has those Spencer eyes, she thought as she reached for the black phone that connected the two visitation areas.
"Luke," she said.
"Barbara Jean," Luke retorted brightly in an attempt to lighten the mood. "Long time no see, Sis."
"Yes, it's been two years," Bobbie agreed quietly.
"So I hear you're getting married again. No accounting for taste I guess." Luke looked at Bobbie and smirked. "And you're already dressing like the dutiful doctor's wife again." He pointed to Bobbie's conservative black pantsuit.
"Oh, Luke, why do I even bother with you," she said, shaking her head and looking down. "I came here to give you some news. Do you want it or do you want to waste all of our time on insults?"
Luke gazed steadily at his sister, and his eyes softened. "Fair enough," he conceded. "Now, how's my cowboy? He was shaken up pretty badly last time he visited. And no letters from him in awhile. I figured it was the holidays. So, what's up?"
"Luke," Bobbie started with hesitation. "Lucky is in the hospital. He had a breakdown on Christmas Eve."
"What's going on, Barbara Jean?" Luke growled with warning implicit in his tone.
Bobbie sighed and fidgeted with her fingernails, concentrating on peeling the red polish on her right index finger. "Luke, he tried to kill himself in the men's restroom at GH. He read a letter from Laura, and we think that was the last straw, what set him off. She basically suggested that he go kill himself. It was an awful letter, Luke. He was already upset at not being able to visit you, and he's upset about Lulu's custody and not being able to look after her himself."
Luke sat there silently with tears in his eyes that built until they threatened to spill and tumble down his lined cheeks.
"He's been receiving treatment, and he may wake up soon. He's been catatonic ever since his surgery to…repair the damage to his wrist."
The tears now wet Luke's cheeks, and his mouth turned down in sadness and grief. "My son is alone."
"No, Luke," corrected Bobbie. "Lucky has his extended family and friends. Even Edward Quartermaine has taken an interest in him. He keeps threatening to teach Lucky how to play golf." Bobbie tittered at the thought.
All of a sudden, Luke burst into loud laugher. He laughed hard with the tears still flowing in his eyes. He slammed the palm of his hand onto the table in front of him. "Hot damn," he said. "My son the golf pro. Edward Quartermaine," he mused. "Run as fast as you can, cowboy."
Bobbie smiled weakly in Luke's direction. "Kevin is an excellent psychiatrist. He's really been there for Lucky, and I have faith in his ability to reach Lucky and pull him out of this."
Luke ran a weary hand over his gray crewcut. "Then why couldn't he prevent this from happening?" he muttered.
"I'm not sure anyone could have prevented this," replied Bobbie. "It was just life happening. Too many bad breaks for one vulnerable boy to handle. All we can do is be there for him and give him all the support that we can. Luke, he might not be able to answer you for awhile, but I do know that he enjoys your letters. Maybe you can send him some more. I'll make sure that he gets them if I have to read them aloud to him myself."
"Okay, Sis," Luke agreed. "That's a good idea. Now what about his bitch mother from hell? What's going to happen to her?"
"We're not sure, Luke. Her trial starts in three weeks. But, Tony and I expect to win custody of Lulu next week."
"I miss my little angel," Luke said wistfully. "Can you take photos of her and mail them to me?"
"You betcha," said Bobbie brightly, glad to talk about something she had control over. "We'll take plenty of photos, and even help her write to you."
"That would do me a world of good, Barbara," said Luke softly. "You take good care of my cowboy, promise me Barbara. Please."
"Yes, of course. I promise you, Luke," said Bobbie.
~*~*~*~
As Luke walked back to his cell, his face turned stony, and he shook with fury. That bitch Laura, how dare she? Now she's trying to kill our kids? His gaze turned steely and his grin never met his eyes. Sonny Corinthos owes me one huge favor. It may be time to collect.
~*~*~*~
Bobbie sighed wistfully as she crossed the prison parking lot searching for her car. I really miss my brother, she thought. We've always been there for one another.
*** "Put this ice on those bruises," twelve year old Bobbie Spencer ordered her brother. A teenaged Luke was lying on his bed, his face covered with bruises that ran the rainbow from black to blue to yellow to green.
She picked up his hand and cleaned the cuts with iodine.
"Owww!" screeched Luke. "Are you trying to kill me?"
"Those cuts will get infected if I don't clean them out," Bobbie stated.
"Did you earn your Girl Scout badge in nursing?" asked Luke sarcastically through swollen, split lips.
"No, but I'm going to go to nursing school so I can be a nurse when I grow up," said Bobbie proudly. "Why do you always have to get into these fights? You're too skinny. You always get beat up."
"I am NOT skinny," protested Luke. "I have a lean physique - deceptively strong. Besides, somebody's got to keep these drunken johns in their place." ***