In the original books there are at least two incidents where poor old Alec has some pretty serious head injuries. In The Black Stallion's Son he's thrown off Satan and ends up hospitalized for a week or two with a pretty bad concussion; seriously, he really should have been wearing a helmet. Later, in The Black Stallion Revolts, he falls from a plane and receives another bad head injury, resulting in blood loss, major pain that lasts for days and amnesia. Both injuries cause him to lose consciousness for a number of hours. This is a bad thing.

I got to thinking and it occurred to me that major head injuries could come back to bite you years later. I spoke to a medical friend (thank you, Gabe) and asked him what could happen.

It ain't pretty.

Repercussion

Belle Ramsay was emptying the bathroom garbage can when the pile of bloody tissues made her stop. What on earth? They had to be Alec's, he was the only one who used the upstairs bathroom since she and Bill's room was down on the first floor—and there was so much blood. He hadn't mentioned anything, and she hadn't noticed any Band-Aids or anything. He would have said something if he were hurt, even if it in passing—well, probably, anyway. And he seemed just fine. Maybe he'd cut himself in the kitchen or down in one of the barns somehow. It could happen easily enough with all the physical work he did everyday. Maybe he was bitten by one of the horses, he could have slipped with a tool or something.

Maybe it was nothing.

Of course it was nothing. If it were something serious she would have noticed it. He was her son and she always watched to make sure he was healthy, much as she knew it annoyed him. Jockeys got injured, it was a simple fact of their lives and she knew this, they all did and that was why she worried so much. She would have seen something if there were anything to see. She made a point of it since she knew he had a tendency of hiding injuries.

Alec was the healthiest person in the world; he almost never got sick, never even got a cold. She asked Alec later that evening but he made a joke about it and changed the subject. With no real explanation forthcoming, she pretty much pushed it to the back of her mind.

About a month later she was walking into the stallion barn, looking for Alec, when she heard the raised voices—a rare thing at Hopeful Farm. Usually everyone was friendly and pleasant, arguments were rare.

"…Because you're a idiot, that's why. You pull this crap again and not only are you gone but I'm make sure you have a hell of a time finding any more stable work, do you understand me?"

"Yeah, sure, but, but Alec it wasn't like that. I swear it wasn't. I was just trying to…"

She heard something being thrown against a wall, glass breaking. "Get the hell out. You're fired, you got that? I want you gone. Now."

"Hey, Alec, c'mon…please. My wife…"

"Not my problem." Alec stormed out of the tack room, gave her a startled and annoyed look as he went into his own office without pausing, the door slamming behind him.

Tentatively Belle went into the tack room. Jack, one of the grooms, was standing there stunned and close to tears. She went over to him, putting her hand on his arm. "What happened?"

"I don't know. I was in here folding some stable blankets and he stormed in, telling me I was doing it wrong and it kind of escalated from there. It came out of left field, no warning." His chin was trembling. "My wife is due in a month, if I'm fired we lose my benefits and the doctor bills will break us."

"I'll talk to him, Jack. He was just telling us yesterday what a good job you're doing—I don't know, I'll talk to him." He looked grateful; afraid to hope he still had a job.

She made her way down to Alec's office, knocked on the door and pushed it open when she didn't hear anything. Alec was standing, looking at the wall of trophies from the Derby, Hambletonian and a score of other major races he'd won as if he'd never seen them before. He turned and smiled at her as if the argument had never happened. "Hey, I was just about to stop over at the house to tell you." He paused, glanced down at some papers on his desk. "I have to go into town for some supplies, 'should be back in a couple of hours."

"All right. Sweetheart, I was just wondering; do you think you'll have a lot of racing to do this spring or do you think that you may be able to spend more time here this year?"

He nodded. "Henry thinks a couple of the new string are ready for some training contests. 'Just some cheap ones to help their seasoning. 'Probably just down at the New York tracks or Saratoga then whatever he has Black entered in." He picked up a halter that was hanging on the back of a chair.

"Alec—what about Jack?"

"What about him?"

"You just fired him."

He looked at her like she was speaking gibberish. "Why would I fire Jack?" He was serious, he wasn't joking. He started out of the office, she trailed beside him. As they passed Jack, Alec paused for a moment to hand him the tack in his hand. "You're doing a great job, Jack—I probably don't tell you enough, but I'm really glad that you're here. We all are."

That was that. The firing and the bizarre argument were never mentioned again.

After that things seemed to revert to normal. Alec was his usual pleasant, competent self and couldn't have been kinder or more considerate to his parents and the various farmhands. He rode the horses they had in training along with Jack to help teach them to run in close quarters and to get used to being paced for speed. Alec was conscientious about the paperwork he was responsible for and was a professional in every sense of the word. In fact it got to the point where even Jack marked down their confrontation as a weird one-off that could happen to anyone. Alec was probably just having a bad day—everyone did once in a while, right?

About a month later Alec told his parents that Henry wanted him to get to Belmont to start really working those two-year-olds. It was only two hours away by car, but the schedule was heavy enough that he'd have trouble getting home too often. He accepted it as part of his job, but the simple truth was that he preferred the farm to the tracks but he knew what had to be done. If the farm was to succeed then they had to get their product out there and racing was the best way to show the racing pros what they had to offer—assuming they won races, of course. Besides, they flat-out needed the prize money to keep afloat; horse breeding was about an expensive and iffy a way to make a living as you could find. Even with the Black and Satan as their top studs, nothing was assured. There were no guarantees.

The next Tuesday, with Alec racing down in New York, Belle was getting a chicken ready for the oven when Bill came looking for her.

"—I just got off the phone with Henry."

Belle went pale, she knew this was leading to something bad just from the tone of her husband's voice and the look on his face. "What?" A racing accident? A car crash?

"It's Alec. He's in NYU Medical Center in Manhattan. He had some kind of seizure or something—they're running tests but they…" He faltered. "They don't know what caused it." He paused again, regaining her composure. "Henry said that Alec's awake and he seems fine, he's just a little disorientated. They're waiting for the test results."

A seizure? "I have to go there." Belle was close to panic. Alec had a seizure? What kind? Why? What if it happened again? What caused it? What if there was some kind of permanent damage?

"I thought you would." Bill nodded at her, he knew that she would insist driving down to be with Alec and would have given his right arm to be able to go with her, but he knew that Henry was there. Alec was being looked after and they were being kept appraised of what was happening. Besides, someone had to be in charge of the farm and if she went, then Bill would have to stay here to overlook the day-to-day running of the place. He'd go down if anything more happened, but with any luck Alec would be himself and as well as he usually was very soon. He had to be.

Three hours later Belle was stepping off the elevator onto the fifth floor at NYU. It was night, dark, and she was a little surprised that they let her up to see Alec after visiting hours even after she told them that she was his mother. She followed signs on the walls to room 547. Stopping in the doorway she was stunned by what she saw. He was lying in the bed closest to the window, sleeping. There was an IV going into his left hand and an oxygen tube around his ears, held in place in his nostrils.

His face, normally tanned, was almost the same color as the sheets. Though she knew it was unlikely, he looked like he'd lost weight; he was gaunt and had dark circles under his eyes. She moved closer. He had a pallor under the paleness of his skin, he looked gray.

He looked injured, sick and whatever was wrong with him was obviously serious.

"I'm glad you're here, he'll be happy to see you." She looked at Henry, standing at her right shoulder, though she hadn't heard him come into the room.

"Does he—I mean, can he speak?" Their voices were low.

He nodded. "He's just asleep. When he's awake he can talk just fine."

"What happened?" He had to be all right, he had to.

He guided her out to the hall, around the corner to a small waiting area with chairs. "He'd just finished riding Sandman earlier today, the fourth race. It was a training race, just to school the colt and everything seemed fine—he came in second by a nose and was weighing out. He stepped off the scale, passed out then went into convulsions for about a minute and didn't wake up for almost an hour. The medics were right there and brought him here. We're still waiting for the detailed test results but the preliminary readings show that there may be some kind of bleeding."

"Bleeding?" Belle was listening with growing horror. What did he mean, bleeding? Convulsions?

Henry's voice was quiet and it was obvious that he was trying to be gentle with her, trying not to frighten her. "Bleeding under his skull."

She stared at him in horror. "What? How? Why?"

"The doc thinks it may be left over from an old injury."

"But…"

"Did he ever tell you about the details when we were trying to get Satan broken to the saddle?"

She shook her head. "I know he fell and hit his head but neither of you ever told me about…"

"Alec was up on him without stirrups, the horse reared up and started to fall over backwards, Alec jumped off. The problem was he slipped when he landed and hit his head on frozen ground. He wasn't wearing a helmet: remember, he was out of commission for more than a month."

"No helmet? He never told me…"

"No, he wouldn't, now would he?" She looked at the floor. What else hadn't he told her?

"But he seemed fine when he finally came home. He was fine." Then, "How could you let him get on that animal without a helmet? Henry—for God's sake, he was young then but you're a professional and you knew how dangerous—how could you and then not tell us?"

Henry looked old, he knew. He'd known when it happened and he'd lived with it every day since. He knew it was indefensible; there was no point belaboring it, not right this minute.

She let it go—for now. "Then a couple of years later when he was in a plane headed out west with Black and the plane went down, he was badly hurt then, too."

"Sure, but then it turned out that he didn't go down with the plane like we all thought. They'd opened the freight door to make escape easier and Alec fell out with all the turbulence. Now the plane was low enough that he wasn't killed but he was pretty banged up and the docs think he may have had a hairline skull fracture from that." Henry watched her face as he talked. "I guess he never told you about that, did he?"

"You know how he is…Oh my God."

"They think—and this is preliminary, you gotta remember—that there may be a slow bleed inside his skull. They think that maybe something happened fairly recently, a fall or something, which tore some vein or artery or something which was weakened by all of that stuff before. There may be a blood clot which made him have that seizure and then pass out."

She hesitated. "Could that have made his personality change?"

Henry gave her a sharp look. "Belle?"

"He's been kind of all over the place the last few weeks. Moody, angry and then he'll be really up and happy. And he doesn't seem to know he's swinging back and forth."

Henry looked out the window. "He doesn't remember collapsing after the race, either."

She wiped the tears off her cheeks. "When should we hear?"

"In the morning. Early, as soon as the doc comes in. He said he'd check this first thing and talk to us." Henry looked at her with sympathy. "Did you get a room for yourself?"

She shook her head, no one had thought about it. "Alec and I were sharing a room over by the track but I'll see what I can find for you closer. I'll just ask the nurses if they can recommend a place." He walked over to the nurse's station, returning in a couple of minutes. "They said that you could use the empty bed in his room, so long as another patient doesn't come it. If one does then you'll have to move over to the chair—is that okay with you? I figured that you'd rather be with him."

Belle nodded. It was late now and she was exhausted from the long day, the strain and the worry. "Thank you—will you be all right?"

"Me? I'm always good, don't you worry about me, you just worry about him, you hear me? I'll be back in a few hours—just have to check up on the horses and do my job. You get some rest." He paused for a second. "Don't you worry none—Alec will be fine. He's tough, he always come out of things with a smile on his face. You'll see."

Belle stretched out on the bed a few feet away from Alec. He hadn't woken since she'd been there, he looked terrible and she was terrified. He was never sick; he always looked healthy, even when he was a small child he was almost never sick—even a cold was rare. To see him stretched out like this, connected to tubes and monitors frightened her more than she thought would be possible. There was so much for him to do and so much to look forward to; one of these days he'd meet some one and settle down, give them grandchildren…

Something woke her around four in the morning and she looked around, finally seeing Alec's eyes open and watching her.

"Mom?"

She crossed the few feet between them and took his hand. "Are you okay? Do you need anything?"

"Why are you here? Who called you?"

"Henry called. You had him worried."

"I'm okay, just tired. I'll be all right as soon as I can get some rest. I'm fine." His eyes were closing, his voice slowing. "They shouldn't have worried you, there was no reason."

"I'll stay with you." She leaned closer to him, kissing his forehead and staying beside him while he fell back asleep. Watching him in the semi-darkened room, she thought that he still looked so young, nowhere old enough to have done everything he had in the last few short years since he'd come home with the Black. They'd thought they'd lost him that time; the ship sank, the authorities said there were no survivors and so they'd held a service for him. Almost four months later they'd gotten a call that he'd be coming home and she thought that nothing could be as bad as that had been, thinking him dead.

Around eight that morning Henry arrived with coffee and a sweet roll for Belle ten he gestured for her to follow him out to a waiting area so they wouldn't wake Alec. The doctor was on the floor and would be joining them in a few minutes.

"Mr. Daily and…"

"I'm Belle Ramsay, Alec's mother."

He nodded to her. "Mrs. Ramsay. I've gone over the test results and looked at both the X-rays and the MRI. It looks like what I mentioned to Mr. Daily here is what's happened. Evidently an old injury has become aggravated and caused a bleed under the skull, causing pressure on his brain."

She went pale. "And that's what's causing his symptoms?" The doctor nodded. "What do you suggest?"

"My recommendation is that we schedule an operation to relieve the pressure."

Belle looked terrified and Henry was struck silent for a few long seconds. "You mean brain surgery?" She needed Bill here, he'd be calm, he'd be strong and not get too upset the way she was about to.

"I know it sounds frightening, but I believe it's the best thing for him at this point. In essence, we drill a hole in his skull and allow the excess blood to drain, removing the pressure on his brain which has been causing the mood changes and seizures. After we get the bleed stopped we should be able to control it with drugs until it's able to heal."

She went dead calm. "When would you like to do this?"

"As soon as we can schedule it—I have an opening this afternoon. The sooner it's done, the less danger of additional damage."

Her eyes were fixed on the man's face. "He may have brain damage?"

"Jesus." Henry stood up, too upset to sit still.

"I know how it sounds, but the bleed is slow enough that there should be a good chance of reversing the symptoms."

"And if you don't operate?"

The doctor shook his head. "The symptoms will get progressively worse."

"How much of this does Alec know?" Belle looked the surgeon in the eyes. Alec was too smart not to know something was seriously wrong, no matter what he said. He'd been around enough hospitals and been injured enough to know when he was in for something real or just under observation. He had to have figured it out.

"I spoke to him yesterday afternoon and explained the possibilities. He agreed with me. Of course, if you'd like a second opinion, I understand and would be happy to introduce you to some good people here in the area. However, I think you'll find that with the scans we have, they will agree with my diagnosis."

She looked over at Henry, looking suddenly very old. She moved closer and slipped her arm around him. "I want to talk with Alec about this, if that's all right."

The doctor nodded. "Of course. When you make a decision—and I wouldn't delay—just have the nurse's station page me. Now, if you'll excuse me, I have rounds."

Belle and Henry avoided looking at one another. Without Alec…if something went wrong, if the operation wasn't a success…Then nothing would matter any more. There'd be no point to the farm, the racing, the breeding program, none of it. Alec was the lynchpin; he was what it all revolved around. Alec was what everyone at Hopeful Farm revolved around and if he weren't there there'd be no reason for his parents to live there. Henry wouldn't care about the racing and training the youngsters like he did now and without Alec he'd have trouble finding a reason to continue. Alec was the point for all of them.

She made her way back to his room to find him sitting up against the pillows and looking out the window. Hearing her footsteps, he turned towards her. "The doctor told you?" She nodded. "It sounds pretty straightforward, Mom. They'll do the operation, I'll have to stay here for a couple of days and then can go back up to the farm to recover. With any luck at all I'll be riding again in a month or so."

She just stood a few feet from his bed, staring at him, not believing how calm he was about this. "Did the doctor tell you when he wants to do this?" He was like his father in this kind of thing—face the problem and deal with it, no muss, no fuss.

"The sooner they get it over with, the better." He held played with the light blanket a little, his fingers smoothing the wrinkles. "He's a good surgeon and this isn't as dangerous as it sounds. Race riding is more dangerous and I do that every day." He managed a half smile for her. "You know me, I'm a fast healer." Her lip trembled and he knew how frightened she was. "Mom, c'mon, don't do this, okay? I'll be okay, I promise. The operation should only take a couple of hours, then I'll be in recovery for a while and then I'll probably have to go to ICU for a day or so but that's it—as soon as they get this done, the sooner I'll be back to normal."

She nodded, squaring her shoulders slightly and clearly scared to death. "I'll be waiting."

***

The next few hours passed slowly, Alec forbidden to eat or drink anything and his mother refusing to leave his side. Finally a nurse came in with a razor, shaving Alec's head. "It will grow back before you know it and this will be cooler for summer, anyway." She was just a bit too cheerful and Alec wasn't in the mood. As soon as the woman left Belle kissed the top of his head, "It doesn't matter, getting better is what matters."

Another hour went by and the doctor walked in. "Okay, they'll be taking you down soon but first you'll get something to relax you. I've got my associate with me today and you're in good hands, Alec. It looks like it should be pretty straightforward and, with any luck, this will take care of everything for you. Any questions?"

"How long a recovery should I expect?"

"A month, maybe two is normal but that can vary."

"And then I'll be able to race again, right?"

"Let's see what happens, Alec, okay? One step at a time. Now try to relax and we'll be getting started pretty soon now."

A moment later a nurse came in and added something to Alec's IV, the relaxant that he'd been told about. Alec looked out the window, purposely not meeting his mother's eyes, nor did she try to force him. A few minutes went by and then he spoke quietly, the drugs starting to take effect. "I'm sorry. 'That you and Dad have to go through this—I'm sorry."

She clenched her teeth for a second, making sure she was in control of her voice. "It's not your fault and you'll be fine in a few weeks, you heard what the doctor said."

"Look, if this doesn't work, I mean if something goes wrong I want…"

"Nothing's going to go wrong." She spoke a little too fast.

He went on as if she hadn't spoken. "If something goes wrong I want you all—you, Dad, Henry—to accept it, get past this and move on."

"I…"

"I mean it. I was talking to the nurse last night and she told me some of the things that can happen and if any of them do…I want you to get on with your life and dwell on this. Things happen; I want you to deal with it and keep going."

She grabbed his hand, the one that didn't have the IV in it, held it a little too tightly. "I don't want to hear this—nothing's going wrong and you're going to be fine. You're going to get better and you're going to ride again and live a long life. You're stronger than anyone I know and you're going to get over this, we're all going to help you—you're going to be all right."

***

The OR waiting room was small, not brightly lit and held one other family group along with a priest they seemed to have brought with them. Alec's parents were there; Bill had driven down as soon as he heard the operation was scheduled. Henry insisting that he'd do more good at Belmont's barns than sitting there watching the clock, though they knew he was simply too upset to wait with them. The two groups didn't interact much, both caught up in their own concerns and fears.

Two hours went by.

The operation was supposed to last a couple of hours, maybe three. The hands on the clock barely moved, no one left to get food or a cup of coffee; they just sat. Once in a while Belle would try to lighten things up a little, mention how Alec had survived things that should have killed him over and over, how he was always landing on his feet and always won when it mattered.

Three hours.

She mentioned again how he'd been in equally difficult and dangerous situations before and had always come through with flying colors.

She even talked about how he'd been declared dead twice, how they'd even held services for him, yet he'd still come through just fine. He'd be all right. Of course he would.

Four hours.

Bill, Alec's father, went to the local market for sandwiches and bottled water that no one touched.

Four and a half hours. The priest from the other family group came over and asked why they were there, who they were waiting for, what the medical problem was and then prayed for them, offering to escort them down to the hospital chapel.

Belle accepted the offer, the others chose to wait where they were.

At just shy of five hours after the operation began, it ended. The family, now reassembled in the waiting area looked up as the surgeon came through the door wearing blue scrubs.

The man spoke without preamble, verging on being blunt though his voice was kind. "He came through the surgery well and is in post-op. In a few hours, or the morning he'll be moved to ICU for observation—that's standard in cases like this. His vitals are strong and it looks like we managed to stop the blood seepage."

"And?" Bill Ramsay wanted to hear the rest; would his son recover or not?

"And we'll know more in a day or two when the analgesic is out of his system and he has some of his strength back. So far it's looking good, though. There was no obvious damage, the pressure has been removed and he has youth and general good heath on his side."

"But…are you pleased with how it went?" Bill seemed at something of a loss as how to phrase what he wanted to know; would his son live and thrive or not.

"I'm cautiously optimistic but it's too early for much more than that. He did as well as I hoped he would."

There was a sense of relief in the room, though the tension was still there and would remain until Alec was back to normal—if he ever was back to normal.

Belle was sitting on the plastic couch, her eyes unfocused. "He just turned twenty-one." It was a softly spoken comment and needed no answer.

Alec was moved up to ICU the next day where he'd receive round the clock care. His parents took turns sitting with him and by the first evening he was awake enough to talk for short periods before falling back asleep. His head was bandaged with a drain, he had an IV in his hand, there was an oxygen tube in his nose. He was wearing a hospital gown and his tan had faded, leaving the pallor that had frightened Belle so much when she'd first seen him a couple of days ago.

But—and it was a big but—his vitals were strong, he was responding well to verbal and physical stimulus and when he was awake he was alert. The initial signs were good.

Then, inevitably, word of his surgery reached the tracks and the press. The second morning Alec was in ICU a social worker came in, asking if the family wished to release a statement to the press since they were getting calls.

Belle and William looked at one another, this hadn't even occurred to them but now that it was mentioned it wasn't really all that surprising. Alec was a public figure, much as he hated the fact. Ever since he'd returned from the shipwreck he'd been in the press, his every move followed and every success—or failure—noted. He received fan letters at every track he rode and it wasn't uncommon for people to come up to him asking for autographs. The tracks counted on his for publicity and two unauthorized biographies were in print.

"I suppose we should. Do you have any suggestions?"

The social worker sat down with her laptop and started writing. The Ramsay's looked over her shoulder and made comments. After about half an hour they had something for the press:

"Alec Ramsay, winning jockey of the Triple Crown aboard Satan, two time winner of the Kentucky Derby and best known as the rider of The Black was hospitalized this week suffering from aggravation to an old head injury, causing internal bleeding and pressure on his brain. Surgery was performed at NYU Medical Center yesterday afternoon.

He is reported to be doing well and is resting comfortably.

While it's still early, hope is high for a full recovery and his return to racing within the next few months."

"Are you sure that isn't too—optimistic?"

Bill looked a question at his wife.

"What if he doesn't recover? What if he has a relapse; you know it could happen, the doctor said he was doing well but he's still in ICU and he isn't better yet." Belle was an intelligent woman and she knew what was between the lines of what they'd been told by the professionals. Alec could have brain damage, the weakened veins could still break and leak blood, he could still die. It was too soon to know what was going to happen and she didn't like tempting fate.

The press release was rewritten to leave out the last sentence.

TBC