As Andree Nerpel lay comatose at Rancho Mirage Hospital in 1968, her mother faced an agonizing decision.
The 18-year-old Nerpel was severely injured in an automobile accident and fluids were creating pressure on her brain. Doctors asked Nerpel's mother, Lillian Rose, whether they should operate to relieve the pressure.
Doctors cautioned Lillian Rose that the surgery would not restore her daughter's consciousness. But they said if they didn't operate, Nerpel would die within days.
Lillian could not bear the thought of losing her only child, who had recently graduated from high school. Hoping for a miracle, she authorized the doctors to go ahead with the procedure. It was a decision she and her family came to regret.
Nerpel survived. Since then, the family has endured the emotional anguish that stems from caring for a woman with only limited brain activity, who cannot communicate in any way or control her bodily functions.
The family's suffering intensified in 1983 when Nerpel, her condition unchanged, was raped and impregnated at the Laurelwood Nursing Home in North Hollywood--an incident that has thrust Nerpel, now 40, into the center of a legal controversy.
Nerpel's family filed a lawsuit against the nursing home, and a San Fernando Superior Court jury awarded Nerpel $7.5 million in damages last fall. But Judge David M. Schacter set aside the award, saying Nerpel's attorney failed to prove that she was aware of her rape and pregnancy or had suffered damages from the subsequent abortion and sterilization.
His decision set off protests by feminists and disabled activists, and the case is now winding its way through the appeals process.
As the debate rages, Nerpel lies in her room at Laurelwood as she has for the last 22 years, only dimly aware of her surroundings and oblivious to having become a cause celebre.
In the otherwise bare-walled room where she lies, a small snapshot is taped to the wall above Nerpel's head. Taken just two weeks before the accident, the photograph shows a well-groomed, shapely young woman in an elegant black dress, with teased blond hair, sophisticated makeup and wide-open eyes.
The woman in the bed below is pudgy from lack of exercise and her brown hair is cut short. Her hand is in a mitt to prevent her from yanking out the feeding tube running into her stomach.
She squints her hazel eyes, then closes them tightly and rolls her face into her pillow. She groans and sighs, but the sounds are probably responses to external stimuli.
Nerpel's physician, Dr. Joel Clarfield, said he does not think that she has the mental capacity to understand that she was raped. The real victims, he said, have been her family members, who have suffered in her stead.
"She is conscious, she just doesn't have any significant connection with what she sees and any thought process," Clarfield said. "She has some recognition of shapes and people, she might be able to identify certain people, but that's really open to a debate," he said.
"She doesn't think, realize or consider, but I think that she probably feels," Clarfield said. "I think on some level she was aware of the rape because it was a different sensation, but the psychosocial consequences of what happened to her are for the people around her."
And by all accounts the consequences have been devastating. Nerpel's mother was tormented by thoughts that she was somehow responsible for Nerpel's suffering, family members say. After the rape was discovered, Lillian plummeted into depression. She died from nervous disorders four years later, while still in her early 60s.
"My daughter never quite recovered from the rape. She always felt guilty for letting her go out the evening of the accident, and with this . . .," said Lillian's mother, Eliane Rose. "It was such an awful blow that something like this could happen."
Eliane Rose, who continues to visit her granddaughter, said she has concluded that Nerpel and the entire family would have been better off if Lillian had not authorized the doctors to use all available methods to try to save Nerpel's life back in 1968.
Immediately after the accident, Nerpel "was totally out of it, as if she were dead. I think they should have left her alone. All the operation did was to bring her to the level that she could feel pain," Eliane said.
"I don't think we did her a favor to let her spend all these years like this," Eliane said. "She could have been at peace."
Shortly before her death, Lillian came to share her mother's conviction that she had made a mistake in keeping Nerpel alive.
"She said, 'Mom, maybe we should have let her go,' " Eliane said.
Lillian, a concert pianist, and newspaper photographer Charles Nerpel married in 1943, shortly after they met when he took the music student's picture for an article.