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    Wish You Were Here:

    by Picoult, Jodi
    “Wish You Were Here” by Jodi Picoult follows Diana O’Toole, a 29-year-old art specialist whose meticulously planned life unravels when she becomes stranded in the Galápagos Islands during the COVID-19 pandemic. Separated from her surgeon boyfriend as borders close, Diana adapts to isolation, forging unexpected connections and reevaluating her priorities. The novel explores resilience, self-discovery, and the fragility of human plans against global crises. Picoult’s narrative blends pandemic realism with introspective character growth, offering a poignant reflection on finding meaning in upheaval. The story’s twist reveals deeper layers about perception and reality, marking it as one of the early literary responses to the pandemic era.
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    Wish You Were Here:

    Chapter 12: Twelve

    by Picoult, Jodi

    The chap­ter fol­lows a patient recov­er­ing from severe COVID-19 in an ICU, strug­gling to rec­on­cile her vivid mem­o­ries of an alter­nate real­i­ty with the harsh truths of her hos­pi­tal­iza­tion. She recalls a detailed two-month stay in the Galá­pa­gos, where she formed rela­tion­ships and expe­ri­enced adven­tures, yet med­ical staff dis­miss these as hal­lu­ci­na­tions. The pro­tag­o­nist under­goes a seda­tion vacation—a process to assess her readi­ness for ven­ti­la­tor removal—while grap­pling with phys­i­cal weak­ness, iso­la­tion, and the emo­tion­al toll of griev­ing peo­ple who may not exist. Her nurse, Syre­ta, attrib­ut­es her con­fu­sion to the trau­ma of crit­i­cal ill­ness, but the patient remains con­vinced of her mem­o­ries’ authen­tic­i­ty.

    The pro­tag­o­nist’s phys­i­cal con­di­tion high­lights the bru­tal after­math of COVID-19: she relies on a feed­ing tube, wears a dia­per, and can­not sit up unas­sist­ed. Yet her psy­cho­log­i­cal dis­tress over­shad­ows these chal­lenges, as she clings to the belief that her Galá­pa­gos expe­ri­ences were real. Syre­ta and oth­er staff mem­bers attempt to reas­sure her, cit­ing sim­i­lar delu­sions in oth­er patients, but their expla­na­tions only deep­en her frus­tra­tion. The pro­tag­o­nist’s des­per­a­tion for val­i­da­tion grows, espe­cial­ly when she dis­cov­ers her phone lacks evi­dence of her sup­posed trav­els, fur­ther iso­lat­ing her in a real­i­ty no one else acknowl­edges.

    The ICU envi­ron­ment exac­er­bates her lone­li­ness, with strict vis­i­ta­tion pro­to­cols leav­ing her starved for human con­nec­tion. Her inter­ac­tions with nurs­es Bet­ty and Syre­ta reveal the strain on med­ical staff and the rar­i­ty of recov­ery sto­ries like hers. When she express­es fears of per­ma­nent brain dam­age from oxy­gen depri­va­tion, Bet­ty reas­sures her that “COVID fog” is tem­po­rary, but the pro­tag­o­nist remains unset­tled. Her agi­ta­tion peaks as she demands answers, refus­ing seda­tion to pre­serve her con­test­ed mem­o­ries. A failed attempt to con­tact Finn, her appar­ent life­line to real­i­ty, under­scores her emo­tion­al vul­ner­a­bil­i­ty.

    The chap­ter cul­mi­nates in a bit­ter­sweet reunion with Finn via video call, where his pres­ence momen­tar­i­ly anchors her to the present. Yet the pro­tag­o­nist’s inter­nal con­flict per­sists, as she ques­tions the nature of her real­i­ty. The jux­ta­po­si­tion of Finn’s tan­gi­ble warmth and her lin­ger­ing doubts encap­su­lates her psy­cho­log­i­cal tur­moil. The chap­ter leaves unre­solved whether her Galá­pa­gos mem­o­ries are a cop­ing mech­a­nism, a neu­ro­log­i­cal side effect, or some­thing inex­plic­a­ble, mir­ror­ing the broad­er uncer­tain­ties of pan­dem­ic-era trau­ma and recov­ery.

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    FAQs

    • 1. What is the MOVE acronym used for in ventilator weaning, and what does each component assess?

      Answer:
      The MOVE acronym is used to evaluate a patient’s readiness to be taken off a ventilator. It stands for:

      • Mental status: Assesses if the brain is receiving enough oxygen to process information and respond
      • Oxygenation: Checks if blood oxygen levels are above 90%
      • Ventilation: Determines if the patient can overbreathe the ventilator
      • Expectoration: Ensures the patient can cough to prevent choking on secretions
        The chapter details this process through the narrator’s experience, explaining how medical staff use these criteria before extubation (as seen when describing the “sedation vacation” process).

      2. How does the narrator’s perception of reality conflict with the medical staff’s observations, and what psychological implications does this have?

      Answer:
      The narrator vividly remembers living in the Galápagos for two months—interacting with people, celebrating her birthday, and having photographic memories—while the medical staff insists she’s been sedated in a COVID ICU. This creates profound cognitive dissonance, making her question her sanity (“I have gone insane”). The psychological impact includes grief for “nonexistent” relationships, isolation from being disbelieved, and existential dread about her mental state. The staff attributes this to COVID-related delirium or PTSD, but the narrator clings to her memories’ authenticity, creating a central tension between medical reality and subjective experience.

      3. Analyze the significance of the “sedation vacation” metaphor in the context of the narrator’s hospitalization.

      Answer:
      The term “sedation vacation” ironically contrasts with traditional vacations. While vacations imply rest and joy, this “vacation” involves traumatic medical procedures (spontaneous breathing trials, reduced sedation) and underscores the narrator’s total loss of agency. Nurse Syreta’s quip—”the only vacation I’ve been on”—highlights the grim reality of COVID treatment: isolation, physical deterioration (feeding tubes, diapers), and psychological distress. The metaphor also reflects the staff’s dark humor in a overwhelmed ICU, where even temporary relief from sedation is framed as a “break.”

      4. How does the hospital’s COVID protocol exacerbate the narrator’s emotional distress?

      Answer:
      Strict isolation protocols—limited staff contact, communication through glass walls, and no visitors—intensify her loneliness and disorientation. She describes feeling like “a bug trapped in a jar,” observed but not comforted. Physical deprivation (being denied water, unable to use her phone) compounds her desperation. The staff’s focus on survival over emotional care (e.g., dismissing her Galápagos memories as hallucinations) leaves her craving validation. This is poignantly shown when she considers “acting sicker” to get human interaction, revealing how pandemic-era medicine dehumanizes patients despite life-saving care.

      5. Evaluate the narrator’s refusal of medication when offered by Betty. What does this reveal about her priorities?

      Answer:
      The narrator refuses PTSD medication because she fears losing her Galápagos memories, even though they cause her distress (“I don’t want my mind erased”). This choice prioritizes preserving her subjective reality over clinical recovery, suggesting she finds meaning in those memories—whether real or imagined—that outweighs the comfort of medical intervention. It also reflects distrust in the staff’s explanations and a determination to assert autonomy in a situation where she’s otherwise powerless, as seen when she insists, “No more drugs.”

    Quotes

    • 1. “It is, according to my nurse, Syreta, the only vacation I’ve been on.”

      This ironic statement about a “sedation vacation” captures the protagonist’s disorientation and dark humor while hospitalized, highlighting the surreal nature of medical trauma and COVID-19 treatment protocols.

      2. “It wasn’t a hallucination… It felt more real than any of this does.”

      A pivotal moment where the protagonist insists her vivid Galápagos memories were real, introducing the chapter’s central tension between medical reality and subjective experience. This quote represents her psychological struggle to reconcile two competing realities.

      3. “I am grieving people who, according to everyone here, never existed.”

      This poignant line encapsulates the protagonist’s emotional crisis, illustrating how her vivid false memories create genuine grief. The quote powerfully conveys the psychological toll of medical trauma and altered states of consciousness.

      4. “I don’t want to lose these memories because of a pharmaceutical that makes me a zombie. I don’t want my mind erased.”

      This refusal of medication reveals the protagonist’s determination to preserve her identity and experiences, even if they’re medically classified as delusions. It shows her prioritizing psychological authenticity over clinical recovery.

      5. “This is real, I tell myself. Finn is real. But I feel the concavity of that statement…”

      The chapter’s closing lines perfectly capture the protagonist’s fractured sense of reality. Even as she acknowledges objective reality through Finn, the “concavity” suggests her lingering doubt and the hollow space where her other memories reside.

    Quotes

    1. “It is, according to my nurse, Syreta, the only vacation I’ve been on.”

    This ironic statement about a “sedation vacation” captures the protagonist’s disorientation and dark humor while hospitalized, highlighting the surreal nature of medical trauma and COVID-19 treatment protocols.

    2. “It wasn’t a hallucination… It felt more real than any of this does.”

    A pivotal moment where the protagonist insists her vivid Galápagos memories were real, introducing the chapter’s central tension between medical reality and subjective experience. This quote represents her psychological struggle to reconcile two competing realities.

    3. “I am grieving people who, according to everyone here, never existed.”

    This poignant line encapsulates the protagonist’s emotional crisis, illustrating how her vivid false memories create genuine grief. The quote powerfully conveys the psychological toll of medical trauma and altered states of consciousness.

    4. “I don’t want to lose these memories because of a pharmaceutical that makes me a zombie. I don’t want my mind erased.”

    This refusal of medication reveals the protagonist’s determination to preserve her identity and experiences, even if they’re medically classified as delusions. It shows her prioritizing psychological authenticity over clinical recovery.

    5. “This is real, I tell myself. Finn is real. But I feel the concavity of that statement…”

    The chapter’s closing lines perfectly capture the protagonist’s fractured sense of reality. Even as she acknowledges objective reality through Finn, the “concavity” suggests her lingering doubt and the hollow space where her other memories reside.

    FAQs

    1. What is the MOVE acronym used for in ventilator weaning, and what does each component assess?

    Answer:
    The MOVE acronym is used to evaluate a patient’s readiness to be taken off a ventilator. It stands for:

    • Mental status: Assesses if the brain is receiving enough oxygen to process information and respond
    • Oxygenation: Checks if blood oxygen levels are above 90%
    • Ventilation: Determines if the patient can overbreathe the ventilator
    • Expectoration: Ensures the patient can cough to prevent choking on secretions
      The chapter details this process through the narrator’s experience, explaining how medical staff use these criteria before extubation (as seen when describing the “sedation vacation” process).

    2. How does the narrator’s perception of reality conflict with the medical staff’s observations, and what psychological implications does this have?

    Answer:
    The narrator vividly remembers living in the Galápagos for two months—interacting with people, celebrating her birthday, and having photographic memories—while the medical staff insists she’s been sedated in a COVID ICU. This creates profound cognitive dissonance, making her question her sanity (“I have gone insane”). The psychological impact includes grief for “nonexistent” relationships, isolation from being disbelieved, and existential dread about her mental state. The staff attributes this to COVID-related delirium or PTSD, but the narrator clings to her memories’ authenticity, creating a central tension between medical reality and subjective experience.

    3. Analyze the significance of the “sedation vacation” metaphor in the context of the narrator’s hospitalization.

    Answer:
    The term “sedation vacation” ironically contrasts with traditional vacations. While vacations imply rest and joy, this “vacation” involves traumatic medical procedures (spontaneous breathing trials, reduced sedation) and underscores the narrator’s total loss of agency. Nurse Syreta’s quip—”the only vacation I’ve been on”—highlights the grim reality of COVID treatment: isolation, physical deterioration (feeding tubes, diapers), and psychological distress. The metaphor also reflects the staff’s dark humor in a overwhelmed ICU, where even temporary relief from sedation is framed as a “break.”

    4. How does the hospital’s COVID protocol exacerbate the narrator’s emotional distress?

    Answer:
    Strict isolation protocols—limited staff contact, communication through glass walls, and no visitors—intensify her loneliness and disorientation. She describes feeling like “a bug trapped in a jar,” observed but not comforted. Physical deprivation (being denied water, unable to use her phone) compounds her desperation. The staff’s focus on survival over emotional care (e.g., dismissing her Galápagos memories as hallucinations) leaves her craving validation. This is poignantly shown when she considers “acting sicker” to get human interaction, revealing how pandemic-era medicine dehumanizes patients despite life-saving care.

    5. Evaluate the narrator’s refusal of medication when offered by Betty. What does this reveal about her priorities?

    Answer:
    The narrator refuses PTSD medication because she fears losing her Galápagos memories, even though they cause her distress (“I don’t want my mind erased”). This choice prioritizes preserving her subjective reality over clinical recovery, suggesting she finds meaning in those memories—whether real or imagined—that outweighs the comfort of medical intervention. It also reflects distrust in the staff’s explanations and a determination to assert autonomy in a situation where she’s otherwise powerless, as seen when she insists, “No more drugs.”

    Note