I spent about six hours at the hospital on Saturday, and for the first time in quite a while, the visit felt noticeably different.

When I first arrived, Gene was asleep and essentially unresponsive. But as some of the sedation gradually wore off, he began to wake up.

At one point, Gene opened his eyes and saw me.

There had been a very visible look of concern on his face when he first came around. Once he realized I was there, that completely changed. He settled. His expression softened, and he seemed noticeably more at peace.

I stayed with him for several more hours.

I held and rubbed his hands, and he responded with a surprisingly good, strong grip. I massaged his legs and feet to help with circulation and comfort. More than anything, the simple physical contact seemed to matter. Holding his hand, touching his forehead and scalp, and just being physically present appeared to reassure him and give him a sense of familiarity and security.

As more of the sedation wore off, Gene became increasingly awake.

Eventually, he was fully engaged with me.

He could not speak because of the tracheostomy, and that was understandably frustrating for him, but he was very clearly trying to communicate. He mouthed words. He looked directly at me. He understood what I was saying.

We tried giving him a pen and paper, but his hands and fingers have been immobilized for so long, partly because the staff had been concerned that he might pull out his tubes, that his fine motor control simply was not strong enough yet for writing.

What mattered to me was that he understood what we were trying to do and consciously attempted it.

We eventually worked out a simpler system using his eyes and blinking for yes-or-no answers.

And he got it.

He could follow the instructions, recognize what I was asking, and respond appropriately.

That was probably the most encouraging part of the entire visit.

Before, when Gene occasionally opened his eyes, he often seemed to stare into space without really focusing on anything. On Saturday, however, his eyes were tracking normally. He looked at me. He followed what was happening around him. The staff checked his eye responses, and those looked good as well.

For a couple of hours, we were actually communicating.

The nurses and respiratory staff also came in several times while I was there and said his numbers looked very good. His heart rate, blood pressure, breathing, and the other vital signs they were monitoring were all looking strong.

His breathing has improved quite a bit too.

He is still receiving respiratory assistance, but the staff explained that the CPAP (Continuous Positive Airway Pressure) machine used to deliver a steady stream of pressurized air through his tube to keep his airways open is now providing only about 20 percent of the support.

Gene is doing roughly 80 percent of the breathing work himself.

That is a substantial change from where he was only several days ago.

They have also been able to reduce the size of the tracheostomy tube in his neck, which gives him somewhat more freedom and comfort when moving his head and neck.

The nutritional situation has improved as well.

Although there had previously been concern that another access route might not be possible, the team was ultimately able to place the additional line they needed. He also now has a feeding tube through his left nostril, which allows them to give him much better nutritional support and additional nutrients that his body has badly needed.

His airway secretions also seemed dramatically better.

When the respiratory team came in to clear his airway, I was expecting the kind of substantial amount of fluid and mucus they had previously been suctioning from him.

This time, there was very little.

The staff noticed it too and specifically commented that he seemed to be doing much better in that regard.

Even Gene’s behavior with the nurses was different.

Previously, when the sedation was reduced, he could become extremely agitated and would sometimes resist the staff when they tried to reposition him, suction him, or perform routine care.

On Saturday, he was much calmer and more cooperative.

He was still very much Gene. There was personality there, albeit clouded by the meds. But he appeared to understand what the staff were doing and was not fighting them as before.

Mentally, he seemed remarkably present.

I saw no obvious sign that he was disoriented during the period when he was fully awake. He knew I was there. He recognized me. He could follow commands and communicate intentionally.

Later, shortly before I left, they gave him additional pain medication.

As that medication took effect, he naturally became groggier again and gradually drifted back into a much more subdued, sleepy state.

But that appeared medication-related.

The important difference was that before they gave it, I had been able to spend a significant amount of time with Gene while he was awake, attentive, responsive, and very clearly there.

A few days ago, his doctors and I were talking about whether he would wake up enough to communicate at all.

On Saturday, he was looking me in the eyes and answering questions.

That does not mean the larger medical problems have disappeared. He still has a long road ahead, and there are important issues with his nutrition, strength, breathing, rehabilitation, and the effects of having been critically ill for so long.

But compared with where he was only a few days earlier, Saturday felt like a significant change.

I am expecting another call from the doctor today. The physician was not there during my Saturday visit, so that conversation should give us a much more detailed medical picture of where Gene stands now and whether what I saw at the bedside is also showing up in the clinical data.

For now, though, it was simply very good to see Gene looking back at me and consciously and intentionally interacting with me again.

Thank you for taking the time to read this.

Alexa