On February 18, Denver serial rapist Brent J. Brents nearly beat 33-year-old Tiffany Engle to death. She was his last victim—and she is also my friend.
The bleeding was putting pressure on her brain. If the intracranial pressure didn't stop increasing, a surgical team would have to go in and relieve the stress. The plan was to monitor the slowly increasing pressure over the next 24 to 36 hours and, if it rose too high, prep her for a craniotomy, a pressure-reducing surgical procedure involving the removal of a piece of the skull and bruised brain tissue.
The Engles waited. They sat with Tiffany and talked to her. They didn't, however, ask her about what happened-they weren't sure they wanted to know. Over the next day, doctors came in and out. They adjusted Tiffany's blood and fluid levels, trying to lessen the amount of fluid volume in her already-swollen body. They monitored the pressure in her brain; it normally registers at a level less than 20, but hers was steadily rising above that. And, as the hours passed, Paul said he could see that Tiffany was deteriorating and becoming less and less responsive.
Around 11 p.m. on Sunday night, Paul Matthew and Andrew took their turn hanging out with Tiffany while the rest of the family took a break in the waiting room. Tiffany had been marginally responsive for most of the day, squeezing fingers and answering direct questions. After a while, Andrew took a walk out to the waiting area to see if anyone else wanted to join them. Finding everyone a little weary and settled in, he headed back to the ICU. Before he reached Tiffany's room, he met Paul Matthew in the hallway. Something was wrong. Tiffany had stopped responding. He needed to find the nurse.
Finding one of Tiffany's pupils fixed and dilated and that she wasn't responding to any stimulus, the nurse alerted Dr. Kathryn Beauchamp, the neurosurgeon. Tiffany's brain had swollen at an unexpectedly rapid rate, and she needed an emergency craniotomy. A flurry of hospital releases fell into Paul and Cheryl's laps. Paul took off for the chapel. Within minutes, doctors gave Tiffany a large dose of diuretic to flush her system of any pressure-inducing fluids, shaved her head, and wheeled her into the OR for brain surgery.
Tuesday Morning, Feb. 22
For nearly 30 hours after surgery, Tiffany remained in a medically induced coma. Her family sat transfixed by a monitor that tracked her intracranial pressure, which fluctuated to near-catastrophic levels. Doctors had told the Engles it could take days or weeks for her to wake up and breathe on her own. And if and when she did wake up, there was no way to really know what to expect. During surgery, Dr. Beauchamp had sawed out a piece of Tiffany's skull to find a bloody, bruised mess inside.