Feldkirch Hospital – Critical Care Unit

I spent part of Thursday afternoon talking to the team of physicians and nurses who care for Paul in the Feldkirch Hospital Critical Care Unit. When engaging with them one realizes just how fortunate he is to be so well looked after in what is a modern, well designed hospital.

In my last entry I reflected on where I sensed we were following the accident, and now on day eighteen, the combination of time and medical care is what is so important. The Medical Team has stabilized him. The tracheotomy procedure has been successful and this has made him more comfortable. However, his breathing remains assisted. He still has his physiotherapy sessions and is watched over constantly by “man and machine”. The drug regime inducing the coma has ended, but he remains well sedated to keep him comfortable.

His recovery rests, in great part, in their hands. This recovery process is marked by peaks and troughs and today they had to drain excess fluid from the brain. It is not always a steady, constant improving path and we need to remember this.

In a sense, the next steps are ones that Paul will take in his own time. The Medical Team remains content and feels that he is where they would generally expect him to be at this stage of the recovery process mindful of the enormous severity of the force of the accident and the blow to his head. I only learned on this visit that he had a fractured skull. They now watch for signs of movement, the coughs to deal with irritation in the throat, leg movements and the perhaps slight movements of the fingers. These are but some important signs and over the next several days and weeks ahead our hope is that we will see them. The doctors cannot place a definitive time frame on these signs. Everyone is different. We cannot expect something definitively will happen tomorrow or on the next day or next week.

Given Paul remains stable the physicians are starting to consider next steps in his recovery process and where best he can be cared for. They are reflecting on identifying, in the area, the best care environment and hospitals that specialize in head injuries and when it may make sense to move him. No decision yet has been taken. These decisions will be important steps in his recovery process and then he would move from the critical care environment into the high dependency environment. We are not there yet.

Penny remains in Austria in a charming family run hotel. They are looking after her very well, are so kind and thoughtful, and it is an easy walk to hospital. She spends time after 11.00am in the morning with Paul, leaves at lunch and then returns in the late afternoon for an hour or so. Graham is with her this weekend.

And so, as we all watch from afar, we must continue to manage our burden of time. We will be patient. Importantly, we will continue to offer up our prayers for Paul’s recovery and especially for Penny, Charlotte and William.

As ever, Charles

Prayer for Paul

Strengthen your servant Paul, O God, to do what he has to do and bear what he has to bear; that, accepting your healing gifts through the skill of surgeons and nurses, he may be restored to usefulness in your world with a thankful heart; though Jesus Christ our Lord. Amen.

Paul Continues to be Stable

Penny flew to Zurich on Monday afternoon and then headed straight out to Feldkirch. She has spent a lot of time with Paul over the last twenty four hours and, indeed, with the medical team caring for him. The doctors had sought to avoid a tracheotomy procedure, but yesterday they elected to go ahead with it. I understand that this procedure will remove the constant discomfort and irritation of the ventilator. It also may help them better manage the infection in his lungs. This procedure has been a success. The surgeons are pleased.

The doctors are continuing to wean him of the drugs inducing his coma. We are nearing the end of that process. They want to see him regain consciousness. There are some indicators that are encouraging. His eyelids flutter from time to time, his left leg is moving and there is slight movement of the fingers on his right and left hand. The physiotherapists have started to treat him.

However, this very slow progress reminds us that the recovery we all hope for will be a lengthy one. The doctors feel that in the next ten days they may start to see signs that will give them a sense of the pace of his recovery, and this will enable them to assess better the extent of what are very severe head injuries. Medicine is an iterative process, and when some approaches do not work, they are abandoned in favor of others. We must expect this.

The best way I can express where I sense we find ourselves is that “The sun rises in the morning and the sun sets in the evening". We now have to deal with the burden of time, and we must hope that each new day helps Paul emerge from what has been a very difficult and critical fortnight. The doctor’s first focus was “life”, but I sense we have passed beyond that stage into another equally challenging one, and one of many along what will be a long journey, with some good days and some bad days.

Peter Briggs, one of Paul’s longstanding friends, spent time over this last weekend with him, and this “English” contact is, I understand, so important as the doctors want to see Paul’s brain re-engage. The sense of the familiar is vital to recovery. These visits are much appreciated by Penny and our hope, over the many weeks ahead, is that his many friends will also be able to give Paul this same one-on-one support.

Graham, her brother, will spend this weekend with Penny, and I know that Paul’s brother Mark and his wife plan to head out again soon. I also fly out from London on Thursday morning to see Penny in Feldkirch. I will see Paul and plan to spend time with him, and over the weekend, I hope to be able to share with you more news of my trip to Austria.

As ever, Charles

Prayers for Paul

Penny and Paul were married at Chelsea Old Church on the Embankment, in London, on the 29th April, 1988. This morning David Reindorp, the Old Church Vicar, remembered Paul and offered up prayers for his recovery. He will be remembered at our Old Church services.

Charles McGregor

Trisha's Prayer

Penny wants to share Trisha's Prayer:

I said to the man who stood at the gate of the year, "Give me a light that I may tread safely into the unknown."

And he replied, "Go into the darkness and put your hand into the hand of God. That shall be to you better than light and safer than a known way!"

Minnie Louise Haskins, 1908