Minutes That Cost an Eternity

The first time Garrett Brann fell into the family swimming pool, he was fished out in a wink. Life saved, no harm done, just a precautionary night in the hospital for the 2-year-old and a fresh lesson for his parents on the dangers of a backyard pool.

The second time Garrett slipped into the pool, on his third birthday, rescue came too late.

“He was supposed to be in his room,” Garrett’s mother, Mieke Brann, recalled. “No one knew he was outside. Apparently, he went out to float this little plastic boat he got earlier in the day.”

Thirteen years later, his parents still don’t know how long their son was submerged.

And they can’t ask him.

The near-drowning left Garrett profoundly disabled, incapable of speech and motion and dependent on 24-hour nursing care at the state-run Fairview Developmental Center in Costa Mesa.

Garrett lives, in one sense, among the forgotten. While news reports often chronicle the drowning deaths of small children or heroic rescues, less attention is paid to survivors who sustain serious injury. It’s as though people assume that once the child is dried off, normal life resumes.

But that often is not the case.

More than 300 children drown nationwide in residential swimming pools or spas each year. Countless others are pulled to safety without injury.

However, more than 2,000 survive but require medical care for injuries ranging from minor to debilitating, according to estimates drafted by the U.S Consumer Product Safety Commission.

And once in a while, the injuries steal almost everything but life itself. In California, 46 near-drowning victims with profound disabilities are housed at five state-run institutions at an average cost of $152,000 per patient per year.

The cold numbers obscure the agony that the survivors’ families endure.

Morning sun fills Residence 209, a window-walled ward on the fourth floor of the Fairview Developmental Center’s main building. Posters and stuffed animals hint at childhoods that might have been.

Six people live here. All suffer from severe brain damage, their beds surrounded by the medical props that help keep them alive. Metal racks to hold IV medications, and the bags of liquefied food pumped directly into the stomach through tubes, stand gleaming in the bright light. The center of the room holds a massive, waist-high bathing platform for the daily washdown.

Two of the patients--Garrett, and Vincent Pastorelle, age 7--are near-drowning survivors, among five such patients at Fairview. Both boys require a constant schedule of special care in a ward they probably will leave only when they die. That might not be for many years, but, prone to pneumonia and infections, the boys’ life expectancy is shortened.

Neither can speak or control motion, which means care-givers must tend to every need.

And the needs are intense.

Because toddlers’ heads are out-sized in proportion to their bodies, they tend to sink quickly when they fall into water, according to drowning-prevention experts. Their brains deprived of oxygen, they slip into unconsciousness after about 30 seconds. Irreversible brain damage begins after four minutes, and death occurs at about 10 minutes.

“Unfortunately, the part that goes first is the part that covers speaking and laughing and playing and saying ‘I love you’--all those things that make children who they are,” said Mary Marlin, a drowning-prevention consultant to Children’s Hospital of Orange County. “We’re made to protect ourselves, so respiration and heartbeat is in the deeper part of the brain.”

Garrett and Vincent were both resuscitated well after their brain cells began dying, leaving them with severely diminished mental capabilities and bodies that have all but shut down.

Human growth is brain-directed, and since the boys’ brains no longer function properly, neither boy has developed in accustomed ways. Their spines curve. Their teeth jut at odd angles. Their joints, further disrupted by lack of use, separate with ease, and both children suffer from dislocations, including hips and knees, that doctors cannot repair without painful surgery that has only temporary results.

And their lungs are weakened. To reduce the physical stress of breathing and the chance of inhaling their own vomit, doctors performed permanent tracheotomies. Both boys breathe through tubes inserted in holes in their throats.

On good days, Garrett entertains himself by blowing air through a diaphragm implanted in his breathing tube, making a series of buzzing and squawking sounds. Both boys have a constant problem with buildups of phlegm, and coughing fits send globs of white goo erupting from their mouths and breathing tubes.

No one knows the level of their mental or emotional development. They cannot respond enough to show it. But both boys smile, laugh, and respond to the caresses of their caregivers and visiting relatives.

Coming to Terms With an Immeasurable Grief

The near-drowning of Vincent had a profound effect on a man who wasn’t there when it happened--his father, Joseph Pastorelle, a San Bernardino County firefighter/paramedic based in Fontana.

Five years ago last May, Pastorelle and Vincent’s mother were separated and heading for divorce. The couple shared custody of their young son. They agreed that Vincent would spend that Memorial Day weekend with his mother. She declined to be interviewed for this article.

Mother and son went to the Downey home of the mother’s boyfriend and, after playing with Vincent in the pool, the two adults stretched out on lawn chairs, with Vincent resting next to them. “[They] fell asleep in the lawn chairs,” Pastorelle said. “There were toys in the pool, and apparently he saw one and was leaning over to get it and fell in headfirst.”

No one knows how long Vincent was under water. Donna Pastorelle and the boyfriend awoke to find him missing.

“She sat up and looked for him,” Pastorelle said. “He was at the bottom of the pool. She dove in and pulled him out.”

Neither adult tried to resuscitate the boy, according to Pastorelle and Downey Fire Department reports.

“He was lying there all blue and purple,” Pastorelle said. “[Firefighters] started CPR and water came out, and they scooped him up and ran to the hospital.”

The first few days were agonizing, Pastorelle said. Doctors warned that the chance of survival was one in 20. As time passed and Vincent didn’t die, they began talking about the lasting effects of brain damage.

“We were thinking, when’s he going to wake up? He looked like he was asleep,” Pastorelle said.

The parents struggled to understand what their son’s future would be.

“The whole reality was starting to set in,” Pastorelle said. “My boy’s not coming home.”

He remembers returning to his own rented home in Chino after several days at the hospital.

“When I pulled into my driveway, I was hallucinating,” Pastorelle said. “When I got out of the car, what appeared to be my son ran up to the glass door [to the house]. I’m freaking out. I started crying. I went in the house and started looking around at the picnic table where he’d eat his breakfast, at the counter where I’d sit with him, at the living room couch where we’d play with his toys.

“I almost had a nervous breakdown. I called my girlfriend to come over and get me out of there.”

He returned once more--to pack and move out.

“Basically, I had to give up my baby,” Pastorelle said, his voice tightening. “He was my only child, Daddy’s little boy and everything. The first year was tough, trying to accept it. It totally changed everything. It changed my personality. How I did things. How I looked at things.”

Pastorelle speaks bluntly about that transformation. His already-difficult relationship with his estranged wife became impossible.

“To be totally honest, I hate her,” he said. “When this happened, everything goes through your mind. How could you let this happen? Then the reality sets in. You just cry.”

“I used to be real easygoing. . . . Things would just roll off my shoulders,” Pastorelle said. “I became resentful. I had a really short fuse. I started to get a temper. I couldn’t sleep--insomnia was hitting me all the time.

“I found myself just getting in the car in the middle of the night, driving down there [to Costa Mesa] just to see him and hold him.”

It was a year before he sensed that he was coming to terms with what had happened.

“My personality started going back to how it used to be,” he said. “I’m not the same person I was prior to this, but I’m not as big a jerk to be around as I was.”

But as a firefighter, it was only a matter of time before circumstances would overwhelm him.

“Two years after, I had a drowning [call] here at work,” Pastorelle said. “It was a kid, about 6, the same as Vinnie. My emotions were going about one hundred miles an hour. I could feel my heart rate going. I could feel myself shaking.

“We got back to the station and I went off to a room by myself and just broke down.”

‘When Your Guard Is Down, the Water Wins’

The human impulse is to wonder how to avoid such tragedies.

Municipal and county building codes require that pools be fenced and spas have covers, and most also require that access from within the house be restricted by self-closing and self-latching doors, and in some cases alarms.

As of January, a new state law set minimum standards for new homes, requiring pools and spas 18 inches or deeper to be enclosed by a five-foot fence with a self-latching gate that opens outward; alarms on all doors opening to the pool, the doors self-closing and self-latching with the release button at least 54 inches above the floor; and pool covers.

But the key factor--attentiveness--isn’t the kind of thing that can be legislated.

Even following the precautions does not guarantee safety.

“Once someone feels that they are absolutely waterproof, because [the child] had swim lessons or for whatever reason, your guard is down,” said Marlin, the drowning-prevention specialist. “And when your guard is down and something is not in place [such as a gate], the water wins.”

In the 13 years since Garrett, the youngest of Mieke Brann’s three children, nearly drowned at their Santa Ana home, she has made regular visits to a son she can’t be certain recognizes her.

Each visit carries its own intensity.

“It depends on how Garrett looks and where I am emotionally, I guess,” said Brann, 48, of Laguna Hills, a school speech therapist. “Sometimes I just walk in there and take care of what I need to. But near his birthday, I’m always weepy.”

Joseph and Mieke Brann’s marriage, they both say, was already disintegrating when the accident occurred. The additional stress turned it to dust.

Mieke Brann has struggled since the accident to dampen the inherent sense of guilt a parent feels over an injured child.

“There is guilt,” she said, crying softly, “but there’s also just a reality that you can’t save them and protect them from everything.”

Joseph Brann ascribes the accident to a convergence of the improbable. They had a solar cover for the pool, but the motor that positions it was in the shop for repairs that Saturday. Garrett wasn’t where everyone thought he had gone--upstairs to his room. And someone during the birthday gathering that day had left a door to the pool area unlocked.

Brann was mowing the lawn and made a turn from the side yard to the backyard when he spotted his son at the bottom of the pool. He dove in, pulled the boy out and got him breathing while his wife telephoned for help.

“I cannot imagine a worse situation to go through,” said the father, who was a Santa Ana police officer when the accident occurred, and who now is director of the federal COPS program for the Department of Justice in Washington, D.C. “Losing a child, even though he is still physically present but losing him in every other sense, is the worst thing that can happen to any parent. It’s been hard, and that’s an understatement. . . .

“I can be watching TV or a movie and you see a child in the water and it hits you. It overwhelms you.”

A Bed, a Wheelchair Become a Child’s World

“This is not a sad place,” insists Anna Taylor, the Fairview unit supervisor for Residence 209.

It’s not a happy place, either.

The day begins about 6:30 a.m.

Diapers are changed, baths given, feeding tubes connected, medications administered and each patient checked for changes in condition. Afterward, the caregivers begin moving patients to class and, depending on the day, physical therapy.

Blue sky and green treetops fill the classroom windows, anchoring a corner of the fourth floor. Inside, the lessons deal less with learning than with exposure.

Special education teacher Susan Barker begins the class with a tape of Woody Guthrie’s “Wake Up” song. She and two aides sing along as they move around the room rubbing the hands, arms and legs of the students, each strapped into special wheelchairs. Some students respond with smiles; most don’t.

Then Barker and the aides--Sophia Ibrahim and Martha Macias--read aloud from the morning newspaper, using it to start current-events conversations that they expand to include the students by asking rhetorical questions about something they just read. They move on to a humor column, reading aloud riddles that the teachers answer themselves.

At the same time, in a day room at the opposite corner of the building, physical therapist Yaszu Tsao puts Garrett through morning exercises. She rolls a vibrating tube up and down his arm; the vibrations, Tsao says, help loosen the muscles in Garrett’s arm and relax the contractions that continuously curl the wrists and hands inward.

Tsao then moves on to physical manipulation, pulling the arms straight in a series of motions, and pushing them backward while bracing the shoulder. She has to be careful because of the ease with which his limbs dislocate. She cannot work on his legs because his hips have already slipped from their joints.

“I think he probably feels pain,” Tsao said as she worked on Garrett’s left biceps, a stuffed monkey curled beneath his motionless right arm. A volunteer sings softly to another patient.

“It’s very painful when you see a child like this,” Tsao continued, “especially when you see the pictures of when they were normal.”

She has two children of her own, ages 5 and 1, and her work, she said, affects the way she deals with them.

“I don’t trust anyone else [with them],” she said.

The morning routine winds down about 11, as patients return to the wards.

Vincent arrives first. His spot is beneath the hall window at the east end of the room; Garrett’s bed is against the same wall at the west end of the room. The boys, linked by similar tragedies, form bookends for a roomful of lost dreams.

A few minutes after 11, a respiratory therapist comes in to hook plastic lines to Vincent’s tracheotomy tube and begins pumping in albuterol, a compound that helps keep the bronchial passages clear.

Vincent blinks as puffs of vapor rise from his throat. Usually, said Isabel Velasco, his nurse, Vincent is alert and smiling in the morning, but this day his mood is subdued. He napped through most of the class but perked up when a volunteer pounded out bouncy songs on the piano.

While Vincent receives his breathing treatment, another worker comes in and lifts him from his wheelchair to his bed. Velasco pulls the privacy curtain and tends to Vincent’s diaper before the respiratory therapist returns. Then it’s time for a nap as the feeding tubes are hooked back up.

In the afternoon, the routine will be repeated--class time, then dinner before preparations for bed.

Velasco arranges Vincent on his sheets, a small pillow separating the knees that dislocate so easily, and tucks a stuffed rabbit under his right arm. A mobile of four tiny Dalmatians twists slowly above his head. Four snapshots decorate the headboard, images of Vincent as a happy toddler, exuding life and energy.

Vincent himself lies facing the window, eyes expressionless, his lips formed into a slight, open smile.