As the touching and incredible story of Jacob Cachia, the boy who survived a devastating brain infection against all odds, hits the shelves this week, we bring you an exclusive excerpt from the book that recounts his family’s harrowing experience from the point of view of his mother Sarah.
“Jacob looks awful. Are you sure it’s just a cold? Look at his eyes, they’re bloodshot,” Sammy told me on that cold January day in 2013.
A week after Chloe and Jacob went back to school after the Christmas holidays, they had succumbed to an upper respiratory tract infection.
Forgive me, I work at a hospital so I’m always having these medical terms thrown at me and somehow, I pick them up. Although it sounds dauntingly complex, an upper respiratory tract infection is, in fact, just the medical jargon for the common cold.
January 2013 was a particularly cold winter, for Malta anyway, and bugs were doing the rounds, so I was not concerned in the least. I took them to the general practitioner, they were prescribed medicine, and after four days they were back at school.
Sammy’s observation, however, was apt: Jacob did look terrible, but I put that down to the fact that Jacob didn’t normally get sick, so it was a bit unusual for us to see him run down. On Monday, January 28, he came back from school complaining of a slight headache. He came up to me and said, “Mummy, I’m going to take a Panadol.”
I remember thinking, fleetingly, that that was odd because he was not usually one to take pills for a minor headache, but I thought that perhaps it had to do with all the studying – right after Christmas he had been swotting hard for his exams.
But the next morning he woke up saying his headache had got worse.
“Tell you what, give school a miss today, don’t study, play on your computer, play your Angry Birds,” I said. He stayed home but he never switched his computer on. Instead he spent the whole morning with me in the living room, sipping hot chocolate and chatting.
We talked about his future, his career choices. He was at his last year at school and I told him we could make an appointment with the career guidance teacher to discuss his options. We talked about his upcoming O Levels as he was worried that he had not studied enough. I remember feeling relieved and glad that for once we had actually held a proper conversation without arguments and grunts, but weirdly, deep down, I had this niggling feeling that something was not quite right.
All the while I was thinking, “How very unusual – how come he’s not playing on his PC?”
By the afternoon he was feverish, and his eyes were even more bloodshot. It kept getting worse and worse, so at 11pm. Sammy bundled him into the car and took him to Accidents & Emergency at Mater Dei, while I stayed home with Chloe.
There, he was seen by a paediatrician and tested for stiffness to eliminate the possibility of meningitis.
Seeing that he had no other symptoms apart from fever and headache, they gave him Neurofen tablets, basic pain-relief medication, and at 2am. he was sent back home. He reacted well to the tablets and by next morning, the throbbing pain seemed to calm down.
The next day, January 31, both Sammy and I were working. So after Chloe set off for school, I checked on Jacob, let him know that I had to go for an important work seminar and that if he needed anything, he was to call me on the mobile.
Barely one hour into the seminar, he texted me, saying that he was not feeling well. I excused myself, rushed outside and called him. His voice sounded tiny. “Mummy, I cannot get out of bed.”
I had no car because I had been given a lift by a colleague, so I called Sammy to see if he could leave work and go and check on him.
Sammy got there in no time and called me.
Deep down, I had this niggling feeling that something was not quite right
“I had to lift him to get him out of bed, Sarah, and I’m practically dragging him to the car – the boy is so weak that I did not even dress him – I just threw a jacket on top of his pjs. I’ll call you when we come out of the doctor’s, okay?” he said.
He called again, about 40 minutes later. The GP, he said, was floating the possibility that it could be a strain of swine flu.
I managed to get a lift back home and as soon as I saw him I was rooted to the spot. His left eye. It had swollen beyond belief. There were no other visual symptoms but he was feverish and limp and kept saying that his head was pounding too hard.
I had seen enough patients at hospital to know that this was no normal headache.
Sammy and I did not stop to discuss: we just looked at each other and knew that this was serious. We did not even consider the private hospital where I worked, but we rushed him to the state hospital. We were on automatic pilot. We knew what we had to do and we got it done.
By the time we reached the hospital, Jacob was looking even worse, if that was at all possible. He could not stand up at all: we had to get a wheelchair to take him into the Emergency Department.
While we sat in the A&E waiting room, Jacob kept telling his father to rub his brow to make his headache better. “Dad, please don’t stop.” The headache, he kept telling us, was getting unbearably painful. I had never seen Jacob complain so much before, not even when he was young and he used to suffer from asthma attacks.
When the paediatrician on duty saw him, she immediately ordered a computerised tomography scan. I was familiar with this scan – it’s that machine that looks like a large mint Polo sweet, so I did not panic. The scan, we were told, would combine a series of X-rays taken from different angles, and the computer would then process them and create cross-sectional images of the bones and soft tissues in Jacob’s head.
The result showed that it was sinusitis. Jacob had a deviated septum which narrowed the sinus channel, it had got blocked and infected as a result of the cold. The infection was bad, but we were reassured that although in rare cases an infection could attack the brain, Jacob’s brain was visibly clear from the CT scan.
He was admitted to the Ear, Nose & Throat ward and there treated with anti-biotics intravenously to promptly control the situation “in the very rare event that it can attack the brain”.
He seemed to respond well to the treatment. The antibiotics appeared to work straight away: the swelling of his eye subsided, and so did his headaches. But his energy levels were still very low. Why was he still so limp? The doctors assured us that he was on the mend but in a sense it felt that he wasn’t.
Although at this point we were obviously very concerned, I was quite calm. I felt safe and comforted that Jacob was being seen to and I was in complete control of the situation … until it all went wrong.
We organised ourselves and Sammy and I took it in turns to spend the nights by his bedside for those four nights he was in the ward.
My parents were picking up Chloe from school and she visited every day when Sammy and I relieved each other at his side.
I remember clearly the second night Jacob spent in hospital: Sammy was staying overnight with him, so I organised for Chloe to sleep over at a friend’s house and I worked the night shift at St James Hospital.
Only when I got to work did I realise that the Malta Eurovision song contest was on television. Usually we’d always watch it together: we’d order a pizza, make some popcorn, and have our very own little Eurovision party. As I glanced at the television screen in the waiting area a wave of melancholy swept over me: look at us, I thought: Jacob in hospital, Sammy by his side, Chloe at a friend’s house – we were scattered all over the place when we should have been together.
By the fourth day, Jacob was still moaning about feeling unwell and was still having dull headaches, but we thought he was just seeking attention.
I kept telling him to stop making such a big deal – and scolded him even – telling him that he was being a baby. How wrong I was.
On the fifth morning, Tuesday February 5, Jacob had a seizure during breakfast and from then on it all spiralled downhill.
Sammy had spent the night by his side, while I was at home with Chloe.
I had woken up at 4am with this unexplainable dread over me and I couldn’t sleep. I cannot quite explain it, but I could not shake off the strange trepidation. I pottered around the house until it was time to wake Chloe up for school and then walked to work, but after less than an hour Sammy called.
“Jacob. He’s having a fit. Come. Quick.”
He hung up, and I burst out sobbing. A colleague, who had been aware of Jacob’s admittance to hospital, immediately offered to drive me there. What was happening? My Jacob. What was happening to him?
Later, Sammy told me that Jacob and he had been chatting to a patient in a neighbouring bed, discussing films. Suddenly, while eating corn flakes, Jacob’s teeth locked and he went into a fit of spasms.
Jacob: My Titanium Man is published by Merlin Publishers. The book is written by Sarah Cachia with Kristina Chetcuti.