A FEW DAYS AFTER my daughter Emma woke up in the ICU after a major surgery, I saw a golden retriever wearing sunglasses and thought I was losing my mind.
I was sitting on the world’s least-comfortable rocking chair, feeling the bones in my spine grate against one another while I watched Wheel of Fortune and Emma dozed. The doctors had cleared her to start walking around a little bit after her surgery, but each trip took something out of her that she could not easily get back. Just getting to and from the bathroom in our ICU suite was an ordeal: a nurse had to come and move all of the devices attached to Emma’s bed to a pole she could wheel with her. These tubes, some of which went into her chest to drain fluid and air, were painful to move, and Emma was usually good and pissed by the halfway mark.
“Get the fuck off of me,” she signed to one of the nurses.
“What did she say?”
“She said she really has to go, and moving the tubes hurts. Is she ready?”
Emma shook her head angrily at me, looked the nurse right in the eye, and raised her middle finger.
“I know that sign,” she said and kept at her work.
Emma continued her profane tirade, silently hurling rude gestures and vitriol the nurse’s way. This anger was unlike her, but I also knew she was in a lot of pain. When I tried to calm her down, the vitriol came my way. I took it, preferring it be directed at her parent—where teenagers usually direct their ire—than at the poor nurse who was just doing her job. Eventually, the rearranging was complete, and the nurse helped Emma out of bed.
Getting up stopped the tirade because Emma needed to grip the IV pole with one hand and the nurse with the other to walk the ten steps across the room and into the bathroom. She was curled like a question mark, head pointed down to the floor, hunched in an attempt to mitigate the pain. It took them almost two minutes to get to the door, and as they did, I eased myself back into the chair. A new puzzle had come up on the screen, and Pat Sajak was telling the contestants that the category was “An Event.” Two words: the first one was long, sitting atop a five-letter second word.
“Anniversary Party,” I said.
The letters played out, bankrupts and lost turns notwithstanding, and soon the solution was revealed.
Anniversary Party.
“Hey! I got it with no letters.”
I looked around, expecting adulation and congratulations, but nobody was there to witness my greatness.
The toilet flushed from the bathroom, then the sink ran, then the door opened.
“Hey, guess what,” I called toward the bathroom and stopped short. Emma was sobbing. “Emma, what’s wrong?”
She wrenched her arm off of the nurse’s elbow and started signing.
“It hurts too much. Kill me.”
“What did she say?”
“She’s in a lot of pain.”
“I’ll let the doctor know.” The nurse took Emma’s hand and made the slow walk back to bed, Emma crying silently the whole way. The process of re-adjusting the tubes, drains, and machinery unfolded in reverse, and I moved to the machine-free side and stroked her hair and told her it would be better soon.
“I want to die.”
Over and over again, even after the nurse finished reattaching everything to the bed and left the room to find the doctor, Emma signed about the doctors not wanting to help her and that she wanted to die. I thought she was just overwhelmed—and boy, did I get it. I was overwhelmed, too, having slept no more than a couple of hours in a stretch since we had been admitted ten days before. I’d gone through the entirety of my wardrobe more than once and was getting to the point where I could smell myself—never good. The barely padded slab that pulled double duty as a couch and fold-down bed had found every spot of arthritis in my body and poked at them, hard. I was sore, tired, and irritable, and I hadn’t even had surgery.
Before long, the doctor came in. His name was Jeremy, and we knew him well from our previous stays. Jeremy was usually jovial—leading with jokes and brimming with optimism. This time, he appeared concerned.
"I'm going to give her a little more morphine, but I don't love this cocktail she's on," he said. The "cocktail" was impressive: ketamine, morphine, regular doses of Propofol, a chalky-white liquid used to put Emma to sleep when her agitation led her to try and remove tubing, Versed—a clear liquid designed to relax her and force her to forget her suffering, Ativan—yet another anxiety-reducer, Scopolamine and Zofran for nausea, and a continuous stream of fluids and antibiotics. It made for a complicated pharmaceutical soup—a chemistry laboratory inside my daughter's body.
I didn't love it, either, but I hated the suffering Emma was going through and my inability to do anything about it. I watched the doctor write the order and the nurse leave to get the painkiller booster out of the locked drug dispenser down the tiled hallway. I watched her come back and use a silver-tipped syringe to draw up the drug from a small vial. I watched her spend thirty seconds wiping the port of Emma's IV line with an astringent alcohol pad before injecting the opioids and then flushing the disinfected port with a small amount of saline. And I watched Emma's body go slack, the tension of the pain released into the heavy air of the room. She lay back and went to sleep. The heart rate monitor changed from a flashing 118 beats per minute to a pedestrian 75.
The nurse left the room and pulled the sliding glass doors closed behind her.
I creaked back into the chair, wincing at the new knots doing so revealed. Wheel of Fortune had ended as the drugs were being ordered and administered, and Alex Trebek was setting up the Double Jeopardy round. I was not faring nearly as well as I had with Pat and Vanna, and this time, I was glad that nobody was around to see me try and guess my way through a run of clues on art history. Then I heard Emma stirring on the bed.
The look she gave was unsettling: a mix of fear and euphoria, a strange combination that did not sit on her face in the manner of her normal expressions. It looked as though someone else was wearing her body.
"Do you see the dots?" She pointed at the wall after she signed. There were no dots.
"What dots, Emma? I don't see anything.”
She started laughing then. It was a sideways laugh, a wrong laugh. A laugh that made no sense.
"They're moving around. Look!" She pointed again.
"No, wait, they're bugs." The mad laughter rearranged itself on her face to display a mad terror.
"Emma, there are no bugs."
Her face was certain. Her hands flew up in front of her face to protect herself, as if they were flying out at her. I pivoted around to put myself between my daughter and the onslaught she feared. I knew there was nothing there, but when you see your kid try to fend off danger, you put yourself in between them and the threat. She cowered behind me.
"See, kiddo," I said and turned around. "There are no bugs."
If you've seen madness on the face of someone you love, you can begin to understand how stories of demonic possession took root. Their body is the same. They have the same nose, and eyes, and mouth. They breathe the same air, but they are not the same person. They laugh differently. The way their eyes move around a room is different. The things you've seen them do for their entire lives one way, they do in a slightly different way. It's like walking into a room where someone has rearranged the furniture in ways you can't immediately identify but which has left every corner, every table leg, every dangerous construction in places where you are sure to run into them.
"Spider," she signed and pointed to an empty spot on the floor and started sobbing. One of the known effects of longer-term (beyond a day or two) stays in an Intensive Care Unit is a particular form of psychosis brought on by the combinations of stress, drugs, immobility, boredom, and the strange never-exactly-day-or-night feel of those units. It’s called ICU Psychosis. Patients often report seeing and hearing things: insects crawling around the room and on their skin, dead loved ones talking to them, demonic faces obscuring the faces of their doctors. Often, paranoia and aggression are accompanied with intense fear. I pressed the call button, knowing something was wrong, and spent the night learning about ICU psychosis in a very non-theoretical way.
The immediate treatment was to push more of the drugs that were causing the psychosis in an attempt to put her to sleep. They would work for an hour or two, during which Emma would lapse into fitful dozes, kicking her legs and writhing under her blankets. While the sleep kept her from conscious awareness of her imaginary tormentors, it did not stop their tormenting.
Around ten the next morning, Emma was mid-doze, and I was sitting up on the rock-hard bed-couch that sat along the back wall of the ICU room. I had not slept in more than twenty-four hours and was feeling utterly out of my depth and more than a little untethered from the world. That's probably why it took a minute to notice the dog sitting outside the room.
Not just any dog but a large golden retriever, with long, flowing fur, wearing a pair of Ray-Ban sunglasses, and carrying a backpack in its mouth. I slowly closed my eyes.
"I thought psychosis was only for the patients," I said.
When I opened my eyes, the dog was still there. He turned his snout in my direction, and I swear that—around the backpack strap clamped in his jaws—he grinned. I looked up and down the hallway outside the room. I was sure I was being punked, but there was nobody there to laugh at me. Slowly, I stood up, walked across the room to the grinning golden, and slid the glass door open along its tracks.
"What are you smiling about?" I crouched down to look the dog in the face—his eyes obscured by the dark lenses—and tried to figure out what the hell was happening.
The dog had no answer. I raised my hand for him to sniff, and he ducked his head into my palm, his soft fur catching between my fingers. And just like that, yielding to the magic only dogs can bring, a little of the tension from the past week and a half dissipated. I scratched the dog behind his ears and felt him lean into my hand. On his collar, where a dog's nametag and license would normally hang, was a Massachusetts General Hospital staff ID card, complete with his photo and the name "Ed" underneath it. I knew then that I had to be dreaming. Had to be.
"Where did you come from, Ed?"
"Sorry about that," called a voice from down the hall. "Ed likes to introduce himself sometimes."
A gray-haired man in a salmon vest was hurrying down the hallway toward the dog and me. A dog whose grin suddenly looked mischievous. I gave him another scratch and stood up.
"I'm Rhett," he called, "and that's my dog, Ed."
I reached out to shake hands and introduce myself, but Rhett held up a finger in the universal "one second" gesture. He reached below the antibiotic foam dispenser outside the room and wiped his hands with a generous dollop of the pungent substance.
"Sorry, hospital rules. I hear Emma likes dogs?"
There are two things that, no matter how sick Emma is, will bring a smile to her face if she's conscious: Maroon 5 frontman Adam Levine and literally any animal that never had a larval stage. It's something the hospital staff has used to try and connect with her when she's struggling, bringing in pictures of their own pets, turning the television to Animal Planet when Emma is sleeping so she'll wake to something she loves, and asking questions about the pets in our family.
"Rhett, you have no idea."
"How do you think she'd like an animal therapy visit today?"
I looked back over my shoulder. Emma was starting to stir.
"I think she'd love one—but just so you know, she's going through some things. Don't be surprised if I'm wrong or she says some tough things."
"Every kid here is going through some things," he replied. "Want to give it a shot?"
I invited them into the room. Ed took the lead and walked right up to the bed. He stood on his hind legs and, more gently than I'd ever seen a dog move, placed his front paws on the bed next to Emma, in between the IV tubing and other medical detritus, touching none of it. Emma opened her eyes. They were the psychosis eyes, and a wrong-sided grin moved along her face. Slowly, she sat up from the waist, her legs remaining flat as her body shifted upwards at a 90 degree angle. In a horror-movie move, Emma's head turned to look at me while the rest of her body remained entirely still. Her grin hadn't changed, and neither had her eyes. Mechanically, she patted her right thigh and then snapped her finger—the sign for "dog"—and then slowly turned her head back to look at Ed.
Shit, I thought.
Rhett knelt down behind Ed.
"Would you like Ed to come up in the bed with you?"
Slowly, robotically, Emma nodded.
Rhett picked up the controls for the adjustable hospital bed and lowered Emma down to make it easier for the large dog to get up. Ed shifted to the foot of the bed, surveyed the landscape, and hopped up, again missing every tube and machine in what appeared to be an intentional act of contortion. He spun himself around a few times and then settled, resting his head on Emma's lap. She repeated the slow head-turn back to me.
"Daddy, is he real?"
I told her that he was, even though I wasn’t convinced myself, and an instant transformation came over Emma. Nothing physically changed, but suddenly it was my daughter looking through her eyes, and not her demons. Her smile was right. Her face fit back on her body, the way I had always known it to fit. She reached out her hand and offered it to Ed. A large pink tongue licked her hand, and Emma started slowly stroking his head. As she pet the dog, Rhett used the controls to move the back of the bed up behind her so she could sit more comfortably.
I invited Rhett into the room to sit down.
"No thanks," he said. "I've sat in those chairs before. I'll stand."
While we talked, Emma continued stroking Ed's fur, and Ed responded by licking her hand every time it strayed close to his mouth. It turned out that Rhett was a pilot for JetBlue, flying regular routes to Florida and the Caribbean. He told me that Ed often flew with him, resting as calmly in the cockpit as he did in the beds of patients. I told him some of Emma's complex medical history, dating back to before she was even born—cancer, mystery GI ailments, chronic pneumonias, a rare disease called cast bronchitis, and persistent tracheal tears. He told me about the special care he took of Ed, feeding him only poached chicken and boiled carrots, and taking him to swim in the ocean off of the house he was restoring in coastal Massachusetts, where he had recently relocated from the beaches of southern California. Ed didn't seem to mind that the water was much colder in the Northern Atlantic than it was in the Pacific.
Before we knew it, the ten-minute planned pet therapy visit had stretched to thirty, and Rhett had to take Ed back on the rounds to meet other patients. Emma took it better than I expected, kissing her hand and rubbing it on Ed's snout. Ed kissed her back and gently backed down off of the bed. Not a single alarm blared from Emma's many monitors while Ed and Rhett were in the room. When they left, Emma was tired, so I reclined her bed, and soon she was deep in a true slumber, calm and still, with regular breathing. I stretched out on the rock-hard couch with an impossibly flat hospital pillow and joined her in her rest.
I wish I could say that Ed and Rhett's visit permanently corrected the ICU psychosis. It did not, but it gave us what nothing else had been able to do: respite. I was able to have a conversation with an adult who was not medical—I was able to be a person of my own for half an hour instead of being solely Emma's caretaker. Seeing the power of the pup's interaction with my daughter allowed me to set down the weight of her suffering for a moment and breathe freely. That brief visit gave me the strength to continue carrying that weight a little bit longer than I might otherwise have been able to—and it brought Emma such happiness in the middle of a time where there was simply no happiness to be had. In the days that followed, as the doctors and nurses and pharmacists plotted a path back out of ICU psychosis, Emma often spoke of Ed during her lucid times. Every time she said Ed's name, her smile was her own.
More than all of the medicine in the hospital, visits from Ed and Rhett helped cure my daughter—maybe not physically, although there were certainly physical benefits: we could see lower heart rates during and after their visits, and Emma's reported pain was lower for hours—but certainly in helping her retain hold of herself through the terror, stress, and pain of the months we spent hospitalized. No matter what ward we were in, Ed and Rhett found us, spent extra time with us, and brought us peace and comfort. Other dogs and owners joined in when Ed and Rhett were in the sky. Daisy the poodle wore matching outfits with her owner. Tucker the Labrador retriever had a way of leaning right into us that somehow made us feel supported even though we were holding his eighty or so pounds up with our own bodies. Every dog and every volunteer who came to see us changed us and our experience for the better. But no matter how bad things were, when we saw the golden retriever with the sunglasses, we knew they were going to get better, at least for a while.
About the author:
Ben Jackson is a writer, editor, narrator, educator, and dad. His work appears in the Boston Globe, The Hill, WBUR’s Cognoscenti, The Penmen Review, Consequence, The Horror Tree, and anywhere else he can con an editor into publishing his drivel. He is the co-host with Alyssa Milano (yes, that Alyssa Milano) of the weekly podcast Sorry Not Sorry and teaches writing at Georgia Southern University. He earned his MFA in Creative Writing at Emerson College in Boston, but at this moment he is almost certainly very sweaty in sultry Savannah, Georgia.
Was in the room with you all.
Written extremely well. Tears leaked down my cheeks as I read about Ed the dog interacting with the daughter.