Saving Bobby

BY BRYN NELSON | STAFF WRITER

February 26, 2006

Bobby Palange, age 3, who was accidentally run over by his father's car in their driveway one year ago. (Newsday / Ken Sawchuk / February 20, 2006)

Bobby wakes up on a Sunday.

In the six days since the accident, he has been seen by a small army of medical specialists: anesthesiology, emergency medicine, neurosurgery, neurology, ophthalmology, radiology, pediatrics. He has received a small pharmacy's worth of medicine.

The anti-inflammatory steroid Solu-Medrol out of initial concern (later dismissed) that he might have a spinal cord injury. Dilantin to prevent seizures. Morphine to fight pain. Versed and Ativan to sedate him and Pavulon to relax his muscles.

Drugs to control blood pressure. Antibiotics to fight infection. A blood infusion and fresh frozen plasma and Factor VII -- the same treatment given to hemophiliacs -- to fight a complication that can disrupt the body's blood-clotting cascade.

Kim Palange has left the hospital only to run errands or ready her other children for school, while her mother-in-law watches Bobby. But Kim is never away for more than three hours at a time. Her anxiety won't allow it.

"If God doesn't take him today, he isn't going to tomorrow either," she thinks as she prays. She hasn't permitted herself to focus on anything except her comatose son and the numbers telling her the pressure inside his head has eased.

It has, despite a CT scan taken at Stony Brook the day after his surgery that shows a brain so badly swollen Egnor believes any neurosurgeon reading only the scan would conclude the child hadn't survived. Within the darkened mass depicted in the scan, formerly sharp details and landmarks are completely obscured, as if snapped by an unfocused camera in dim light.

And yet the intracranial pressure was essentially normal, suggesting that a rare separation between swelling and pressure had been achieved by expanding the space available to Bobby's injured brain.

Robert has rejoined Kim at their son's bedside, released the morning after the accident with a not-guilty plea in Suffolk County Criminal Court on charges of second-degree criminal contempt for violating the restraining order. An amended order of protection has permitted the home improvement contractor to help care for the couple's other four children.

And he has, staying busy with them and with errands and bills to keep the overwhelming sense of guilt at bay.

Kim's cousin JoAnn has become cautiously optimistic, after her own fervent prayers for a few more hours of life for the boy: "God, let us make it through the first 12."

And then, "All right, let us make it through the first 24."

When the Stony Brook staff begins to wean Bobby from the pentobarbital on Saturday and then from the Versed and morphine and breathing tube on Sunday morning, maybe the worst is behind them.

A few hours later, the pressure within his brain shoots up. So does the carbon dioxide within his blood, while his heart rate and blood pressure fall and he struggles for air.

Whether he's had a seizure, a common complication after head injuries, likely will never be determined. But the artificial coma keeping him in a medicated torpor has dissipated too soon, and his body is rebelling.

Kim sees a blur of hospital staff running into his room.

She knows enough to stay out of their way. But she can't shake the thought that begins to form in her head. Instead of going through it all again, the nightmarish back and forth, the suffering, maybe it would be better for him to just ... go.

But he doesn't.

With more Versed and Pavulon and morphine and the reinsertion of his breathing tube at 3 p.m., Bobby stabilizes and re-enters his medicated coma until the morning of March 2.

Nine days since the accident, and so much left unknown.