A Week at the Lake

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to a level we can understand.”
    Unable to speak, Mackenzie nodded her agreement. This was Emma’s brain they were talking about. Emma’s life.
    â€œOkay,” the doctor said. “Traumatic brain injury causes the brain to swell—just like the swelling that happens when you injure a knee or an elbow. But the brain is trapped inside the skull and as swelling increases, it can raise the pressure inside the head. If it gets high enough it can cut off the blood flow to the brain. That results in brain death.”
    They nodded carefully.
    â€œSteps have already been taken to alleviate the pressure. Dr. Markham, her neurosurgeon, has inserted an external ventricular drain, or EVD, which is inserted through a hole in the skull.”
    Bile rose in Mackenzie’s throat at the thought of a drill piercing Emma’s skull. She saw Serena swallow. A hand fluttered to her throat. Mackenzie prayed she wasn’t going to make some sick joke about the use of power tools. Serena remained mercifully silent.
    â€œWhat happens next?” Serena asked.
    â€œFor now our best course is to continue doing everything possible to reduce the swelling and to keep the brain as inactive as possible while we monitor everything carefully.”
    â€œAnd what are her chances of a full recovery?” Serena asked the question Mackenzie was afraid to.
    He studied their faces. “Every individual and every set of injuries responds in a different way. Many people with coma from head injuries do make a full recovery.”
    They sat for a few long moments trying to absorb all that Dr. Brennan had said.
    â€œCan she hear us?” Mackenzie finally managed to ask. “Even though she doesn’t react, can she hear what’s going on?”
    â€œWe don’t know. There are reports of patients waking after coma and mentioning things that they heard or even saw, though often in some sort of skewed way or as part of what they experienced as a nightmare.”
    He looked at them and added, “If you want my advice, I suggest you leave. Have a shower, some real food, and a better night’s sleep than you can get in the family lounge.”
    â€œWe don’t want to leave Em alone,” Mackenzie said. “I mean, what if something happens and we’re not here?”
    â€œWe’ll call you. Her vitals are good. She’s relatively stable. And I promise you she’s in good hands. If she worsens in any way, the nurse on duty knows to call you right after she beeps Dr. Markham and me.”

    T he car took them to the Carlyle, where they checked Emma and Zoe out of their suite, retrieved their luggage, then drove to Serena’s brownstone in the Village where the driver, unlike that long-ago cabdriver who delivered Serena to her first New York apartment, carried their luggage to the appropriate bedrooms. Emma’s suitcases were tucked into the back of Serena’s walk-in closet so that Zoe wouldn’t have to deal with or stare at them.
    They were tired and raw, the worry about Emma written on all their faces. Serena was grateful when Mackenzie turned their attention and conversation to their surroundings.
    â€œThis place is gorgeous,” Mackenzie said when they reassembled in the kitchen, which dominated the great room and opened onto a walled garden. “It’s light years from that walk-up over on Bleecker that you and Emma were living in when wefirst met. And it’s so much bigger than your last place.” Although they’d spoken on occasion, there had been no get-togethers once the lake house retreats had stopped. Serena had had no reason to visit Indiana, and if Mackenzie had been in New York she’d never said so.
    â€œThanks.” Serena had not grown up poor and Charleston was certainly no shirker in the historic home arena, but she could still hardly believe the 1901 West Village brownstone belonged to her. “It was only partially renovated when I

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