As Andree Nerpel lay comatose at Rancho Mirage Hospital in 1968, her mother faced an agonizing decision.
The 18-year-old Nerpel was severely injured in an automobile accident and fluids were creating pressure on her brain. Doctors asked Nerpel's mother, Lillian Rose, whether they should operate to relieve the pressure.
Doctors cautioned Lillian Rose that the surgery would not restore her daughter's consciousness. But they said if they didn't operate, Nerpel would die within days.
Lillian could not bear the thought of losing her only child, who had recently graduated from high school. Hoping for a miracle, she authorized the doctors to go ahead with the procedure. It was a decision she and her family came to regret.
Nerpel survived. Since then, the family has endured the emotional anguish that stems from caring for a woman with only limited brain activity, who cannot communicate in any way or control her bodily functions.
The family's suffering intensified in 1983 when Nerpel, her condition unchanged, was raped and impregnated at the Laurelwood Nursing Home in North Hollywood--an incident that has thrust Nerpel, now 40, into the center of a legal controversy.
Nerpel's family filed a lawsuit against the nursing home, and a San Fernando Superior Court jury awarded Nerpel $7.5 million in damages last fall. But Judge David M. Schacter set aside the award, saying Nerpel's attorney failed to prove that she was aware of her rape and pregnancy or had suffered damages from the subsequent abortion and sterilization.
His decision set off protests by feminists and disabled activists, and the case is now winding its way through the appeals process.
As the debate rages, Nerpel lies in her room at Laurelwood as she has for the last 22 years, only dimly aware of her surroundings and oblivious to having become a cause celebre.
In the otherwise bare-walled room where she lies, a small snapshot is taped to the wall above Nerpel's head. Taken just two weeks before the accident, the photograph shows a well-groomed, shapely young woman in an elegant black dress, with teased blond hair, sophisticated makeup and wide-open eyes.
The woman in the bed below is pudgy from lack of exercise and her brown hair is cut short. Her hand is in a mitt to prevent her from yanking out the feeding tube running into her stomach.
She squints her hazel eyes, then closes them tightly and rolls her face into her pillow. She groans and sighs, but the sounds are probably responses to external stimuli.
Nerpel's physician, Dr. Joel Clarfield, said he does not think that she has the mental capacity to understand that she was raped. The real victims, he said, have been her family members, who have suffered in her stead.
"She is conscious, she just doesn't have any significant connection with what she sees and any thought process," Clarfield said. "She has some recognition of shapes and people, she might be able to identify certain people, but that's really open to a debate," he said.
"She doesn't think, realize or consider, but I think that she probably feels," Clarfield said. "I think on some level she was aware of the rape because it was a different sensation, but the psychosocial consequences of what happened to her are for the people around her."
And by all accounts the consequences have been devastating. Nerpel's mother was tormented by thoughts that she was somehow responsible for Nerpel's suffering, family members say. After the rape was discovered, Lillian plummeted into depression. She died from nervous disorders four years later, while still in her early 60s.
"My daughter never quite recovered from the rape. She always felt guilty for letting her go out the evening of the accident, and with this . . .," said Lillian's mother, Eliane Rose. "It was such an awful blow that something like this could happen."
Eliane Rose, who continues to visit her granddaughter, said she has concluded that Nerpel and the entire family would have been better off if Lillian had not authorized the doctors to use all available methods to try to save Nerpel's life back in 1968.
Immediately after the accident, Nerpel "was totally out of it, as if she were dead. I think they should have left her alone. All the operation did was to bring her to the level that she could feel pain," Eliane said.
"I don't think we did her a favor to let her spend all these years like this," Eliane said. "She could have been at peace."
Shortly before her death, Lillian came to share her mother's conviction that she had made a mistake in keeping Nerpel alive.
"She said, 'Mom, maybe we should have let her go,' " Eliane said.
Lillian, a concert pianist, and newspaper photographer Charles Nerpel married in 1943, shortly after they met when he took the music student's picture for an article.
Andree was born in North Hollywood seven years later. An only child, she was doted on by her parents and grandparents, who lived in an adjacent house. And Andree became the subject of a series of stunning black and white photographs by her father.
Eliane now lives in the house that once was inhabited by her daughter's family. Andree's bedroom, with its door closed, is still filled with the furniture she selected, as though her personal possessions are now in storage.
Eliane rarely goes into Andree's room, but she treasures the photos kept on a shelf in the elegantly furnished living room, which has a hazy, sepia-toned quality as the late afternoon sunshine filters through heavy beige drapery.
Sitting at a table near the window, Eliane sorts through a pile of black and white photographs and yellow, torn newspaper clippings. The photos depict a happy young girl, doted on by the adults around her.
As a toddler, Andree chewed on a pipe with her laughing grandfather. When she was 3, Andree and her mother modeled matching leopard-skin bathing suits on the beach for a fashion feature in a local newspaper.
Later, she mugged for the camera while cooking a Thanksgiving turkey. And, dressed in pink crinoline, she celebrated her fourth birthday with playmates in the back garden.
At age 6, Andree traveled to Belgium with her grandmother and great-grandmother. Eliane recalls that even at such a young age, Andree was "sweet and easy to travel with."
As an adolescent, her grandmother recalls, Andree loved horseback riding as well as playing the piano. Her parents divorced when she was still young, but Charles Nerpel continued to play an active role in his daughter's life, taking her on frequent outings and excursions and participating in family events.
Nerpel matured into a thoughtful, somewhat shy teen-ager who spent many hours in her room reading. Her grandmother recalls Andree as a good writer with a talent for vivid descriptions of situations and people.
Even as a teen-ager, attending Grant High School, Nerpel continued to spend much of her time with her family. Although she was not a social butterfly, she had close friends to whom she was intensely dedicated and loyal.
On the night of the accident, she and a girlfriend had gone to feed a cat belonging to another friend, who was out of town.
The accident dramatically altered the lives of each of the family members.
"We have never been the same," Eliane said.
Nerpel's father lives in the San Fernando Valley but rarely sees his daughter and refused to be interviewed for this article. Eliane said it has always been too painful for him to visit the shell of a girl once at the center of his tightknit family.
The rape was another devastating blow for Eliane.
"I can't sleep anymore. I just rehash all of this over and over. And even when I finally fall asleep from sheer exhaustion, it is never a good, deep sleep," Eliane said. "It is something that is with you day and night."
Until Lillian's death, Eliane and Lillian Rose shared responsibility for daily visits to Nerpel. Every day for 19 years, one or the other or both would go to the nursing home and spend time with her.
Now, since her daughter's death, Eliane has shouldered the burden alone. She has not missed a day in three years, she said.
"It has become an obsession with me since my daughter's demise," Eliane said. "I can't even go away for a weekend. But it is a comfort for me to know that I am near my granddaughter."
Each afternoon, she drives the short distance from her North Hollywood home to Laurelwood, where she brushes Nerpel's hair, whispers in her ear and fusses over the blankets and pillows.
Eliane regularly trims her granddaughter's nails and cleans her teeth; she talks to her as if to a tiny baby who cannot understand words--only tone of voice. The staff members know the small, polite lady, who they warmly greet as "Gramma Rose," but Nerpel gives no indication of recognizing her. Still, Eliane said, she is compelled to keep up the daily routine.
"How do I know that way down deep, instinctively, that she doesn't feel something?" Eliane asks. "Why would she smile when I hold her hand or stroke her hair?"
It was Eliane who, in 1983, realized that her granddaughter had missed several menstrual periods and might be pregnant.
After the pregnancy was confirmed, Laurelwood administrators notified the state Department of Health, and a state health investigator cleared Laurelwood of responsibility, said Richard B. Castle, the attorney for the nursing home.
But no criminal investigation was ever conducted to try to identify or apprehend the rapist.
"From a practical standpoint, there was absolutely no way of knowing who did it," Castle said. "If the police had been called, they would say, 'What do you want us to do? What can we do? We have nothing on which to start an investigation.' "
However, Eliane maintains that if the nursing home had made an effort, it could have found the rapist, who she believes was a male staff member who attacked Nerpel at night when most other patients were asleep. But the nursing home did not want to draw attention to the problem by launching a criminal investigation, Eliane said.
"They covered it up, trying to make it appear as if a stranger might have done it," Eliane said.
Eliane said it was Lillian who decided to file a civil lawsuit against the nursing home for negligence.
If Nerpel wins any money, it will be put in a trust for her medical expenses, since she cannot possibly spend it in other ways. Her monthly medical bills are now paid for by Medi-Cal. If necessary, Medi-Cal will continue to pay the bills as long as Nerpel lives.
But Eliane, who said she felt obliged to continue with the lawsuit after her daughter's death, said her top priority is not to secure the money for her granddaughter. More importantly, she said, "I want it to be known that these things happen in nursing homes."
One of Eliane's biggest concerns is what will happen to Nerpel after her own death. She said the nursing home staff gives Nerpel better care because they know her grandmother will be coming to check on her condition.
"She will probably outlive me because physically she is very strong," said Eliane. "I just pray that I have the health and strength to continue. It is my only purpose in life right now. It gives me motivation."