Stroke

by Ricky Monahan Brown

  ‘How do you think these logic problems are going to help you when you get home?’ George asked one day.

  My vocabulary remained healthy enough that I thought about responding, ‘Are you fucking kidding me?’ Something was happening in my head, though. Inappropriate behaviours were receding. I was able to self-censor, this time.

  George’s enthusiasm was indicative of the fact that she was a student on work experience, and she too moved on soon enough. She was replaced by Liat: the French for ‘milk’, but with the vowels reversed.

  I made that one up on my own.

  Liat was no less enthusiastic than the work experience therapist, but not quite as delusional. She and I quickly struck up a rapport. She was only slightly less tiny than the assembly line brunettes, but her smile filled a wide, rugby prop forward’s face. Appropriate, because she was a South African and we shared an enthusiasm for the game. I told her about one of my childhood heroes, the international hooker, John Allan, who played for Scotland in the early nineties before returning home to play for the Springboks when they were readmitted to the fold in the wake of apartheid’s abolition. Scotland and South Africa have more in common than horny-handed farmers and horny-headed front row forwards. In conversation with Liat, I recalled from my legal education that the two countries share unusual jurisprudential characteristics, in that each maintains a legal system that is founded on Roman civilian pillars supplemented by common law characteristics.

  From this moment on, Liat and I were firm friends. It turned out that she had studied in Edinburgh and we both had an affection for the entertainment output of the BBC. Unusually in America, where – outside the hipster havens of Brooklyn and elsewhere – puns truly are regarded as the lowest form of humour, we shared Alfred Hitchcock’s assertion that they are the highest form of literature. I told Liat of my love of the form after she presented me with a set of quizzing puns and then each weekday, she would present me with a new set of wordplay posers. They got harder each day. Meanwhile, with the return of my phone, Beth and I had resumed our remote Scrabble games. I began rustily, but was soon playing lustily, complaining four days after the phone’s restoration that the app’s rejection of the proper noun Pict was a symbol of the oppression of my countryfolk.

  Although this typically Scottish complaint was couched in Pythonesque terms – ’elp! I’m being oppressed! – and I was doing exceptionally well in speech therapy, something inside my brain had changed. Remembering things and organising tasks took a new effort and focus. Despite – or because of – my mind’s new tendency to freewheel uncontrollably, I found myself having to make an effort to slow down my thoughts and think more consciously. Without this control, my thoughts would tumble downhill. Any attempt to grasp the nearest support was a scrabbling for shallow-rooted vegetation that gave way as soon as I grabbed it, leaving me to accelerate into a car crash of jumbled, broken and dead thoughts. Something had to be done.

  Fortunately, a conversation with Dawn the recreational therapist led her to come by the ward with a collection of guided meditation CDs, and I was led back to the poet Hon’ami Kōetsu’s river. As my mind rebuilt itself, I had time to reflect on every thought. This was my superpower. Every thought was examined from every angle and refined before I would deem it fit for production; a tangible result that I could then sand and polish further. Eventually, it became a perfect, shiny pebble. I learned to walk it to the shore and skim it back into the sea. The stone’s ripples would last for a few seconds, then it was gone.

  My brain was working differently. Everyone knew this. It was time to find out why.

  One cold autumn day, I was helped onto a gurney by the nurses and rolled along the corridor to the elevator bank. We took the controlled fall to the ground floor. Just as I was deciding that gurney was my new favourite form of transport, and that whoever consigned the sedan chair to history had made a serious misjudgement, the porter trundled me past the serious-looking reception desk towards the glass doors that subtly separated me from the outside world. Although I had reached a hand out to it through social media, it was still a shock to see it. As our apartment on 15th Street had receded into a bleary netherworld, there was just my ward, the therapy rooms and the office I imagined when I thought of Beth tapping away the working day. Now I knew that the outside world still existed, and it was cold.

  Fortunately, our destination was right on the sidewalk: the large, silver truck that had sat quietly outside on the day I was brought to HJD contained an MRI unit.

  I had never been subjected to magnetic resonance imaging before, so I wasn’t sure what to expect. My father had once told me that it’s a claustrophobic experience. Before I was helped onto the gurney, I had spent an hour propped up against my pillows filling in an incredibly detailed preparatory questionnaire that asked about any metal inside my body and any issues I might have with confined spaces and whether I had any cosmetic tattoos and if I had an artificial eyelid spring and if there was a bullet or shrapnel inside me. The ominous warning signs pasted to the door of the imposing silver truck were depicted in thick black lines. I didn’t know what they were meant to represent, but they were not cheery, and were obliterated in turn by other foreboding, forbidding, diagonal red lines. Appropriately, my mind was quickly filled with images from comic books.

  Dr Bruce Banner, bathed in the full force of mysterious gamma rays, his eyes all yellow terror and his body torn by the harsh black lines that would curse him as the Hulk.

  Magneto, the nemesis of the X-Men, his face contorted by rage, unable to control his mind as it bent a metal fence.

  Dr Jon Osterman bathed in radiant light, his skeleton exposed as coal-coloured daubs when he is erased from time and space. Osterman, who would painstakingly rebuild himself atom by atom and emerge as Dr Manhattan, a being with radically altered perceptions and priorities whose only remaining link to humanity was his girlfriend.

  Inside the truck, I was slid onto the patient table. The patient table glided into the scanner, a grotesquely huge bobbin within which there was a magnet, gradient coils and a radio frequency coil. The inner wall of the cylinder containing me was an inch from my nose. The little jack that had been inserted into the tattered remains of my inner elbow began pushing the contrast agent into my system. The MRI technician retreated behind the cabin wall, and the process began. The machine began to buzz and clang and Sturm und Drang.

  The noise indicated that the scanner was detecting a radio frequency signal emitted by excited hydrogen atoms in my body, using energy from an oscillating magnetic field applied at the appropriate frequency. Fun fact – in research and industry, MRI is known as NMR – nuclear magnetic resonance. The medical world prefers the term MRI.

  The technician stayed behind his little wall.

  My scan produced two pictures of the thought that had been niggling at my doctors. Each was longer and thinner in shape than one would imagine. Yet the magnetic images were tangible, kind of like the life described by a sonogram.

  They were sclerotic-looking, like a finger in a painting by Lucien Freud, but smaller. Knobbly, like a crunchy, cheese-flavoured cornmeal snack.

  But smaller.

  The two terrifying brain aneurysms that cemented my transformation to this new life were each around two millimetres wide.

  I knew nothing of this yet. After the scan was completed and I was wheeled back to Room 920, my unlikely miracle breezed in. She moved as easily and effortlessly as ever, as if gliding between thermals. On this day, Beth was a smiling vision, her exhaustion hidden by black ankle boots, a houndstooth skirt and caffeine molecule earrings. Unbeknownst to me, she was carefully choosing her outfit before she left the apartment each day so her appearance in the ward each morning and evening would cheer me and inspire me to come home. This didn’t register with me, because she never appeared anything other than beautiful and put together in my eyes.

  The effort was working, nevertheless.

  Yet again, Beth took her seat next to the bed, and my c
law-like left hand between hers. I could have wept with gratitude in the face of this tenderness. Of course, and as always, we had a lot to talk about. Once again, weeping would have to wait.

  ‘How was your day, Baby?’

  I told her about the interminable questionnaire and the terrible, clanging racket the machine made.

  ‘Apparently the reason the patient information form is so long is that, if you have, say, a metal implant from before the mid-eighties inside you – or even permanent eyeliner – the machine’ll pull it out of you. They’re worried this will fuck you up. And their one-million-dollar machine. In ascending order of importance.

  ‘So, to distract you from the noise, the claustrophobia and the possibility of a bullet tearing through you from the inside, you get headphones and music.’

  It sounds quite calming, but I didn’t get to choose the MRI playlist. If I had, I would have picked, in order of preference, not overwrought R&B vocal histrionics, not a shit Police rip-off, and not the Eagles. I had a similar take on the Eagles to Jeff Lebowski in The Big Lebowski: I’d been having a pretty rough time of it, and the Eagles? Let’s just say, the Eagles weren’t helping. Now I think about it, the source of the claustrophobia complaints seems pretty clear.

  However, I’d have to imagine that no matter how much I might have appreciated it, a rehab joint couldn’t get away with wall-to-wall Joy Division.

  Even worse, the technician’s instructions were piped straight into my brain by the headphones that were provided, too. As I lay in the capsule, surrounded by sterile white, I was quite calm. Then, over a twelve-second period, the following instructions were relayed:

  ‘You’re going to have to keep your head still.’

  ‘Don’t move your head.’

  ‘Keep your head still.’

  ‘Make sure you don’t move your head.’

  ‘That’s it, keep your head still.’

  All of a sudden, I wondered what, exactly, was going to fall out if I moved my head.

  Back in Room 920, I was enjoying getting to share this human experience with someone who cared. I was transported from a world of pain and moans. Beth was in her element. Having spent weeks seven hundred miles from home during her mother’s cancer treatment, she knew her way around a hospital the way a burglar can walk straight to the valuables in a strange house. She had told me before that she had been waiting for the modern world to formalise and monetise the position of ‘muse’. At last, in inspiring my recovery, she had a vocational mission.

  We had a fun evening together, relating our days, laughing and filling in menu cards. Then all too soon, it was time for Beth to leave.

  I was tired, but as was so often the case in the evening in HJD, sleep did not come quickly. As I tortuously tossed and turned, a vision of the instrument of my transformation appeared to me. Like the Hulk’s gamma rays, and Dr Manhattan’s radiation, I saw my stroke constructed of angry black slashes that conveyed destruction, desolation and despair. Yet, as I turned it in my mind like a 3D model, I made friends with the angry, oval head with the matted hair, the jagged mouth and eyes like piss-holes in the snow. I decided to have his image tattooed on my left shoulder, opposite the black heart that I had had permanently inked for the temporary tattoos Beth and I had got on that early date. I had discovered I had two aneurysms, ticking like bombs in my head. It should have been a terrible day, but maybe, things were turning around.

  In another part of my dream, a truck driver looked at the clock on his dashboard and accelerated, picturing the lilies he wanted to buy for his girlfriend.

  A clock. A truck. A bunch of flowers.

  10

  Occupational Therapy and Dream States

  Most mornings, the whiteboard at the end of my bed indicated that speech therapy would be followed by occupational therapy. Possibly because the very idea of OT has been derided as one step from charlatanism and quackery, occupational therapists will tell you that this branch of treatment has a long and storied history reaching back to Greco-Roman times. After falling out of favour in the medieval era, the roots of occupational therapy spread in Europe during the Enlightenment. Then, a real predecessor to OT emerged in the nineteenth century Arts and Crafts movement, which was a reaction to the monotony of work in capitalist society, even though my job in midtown Manhattan wouldn’t be filled for another hundred years.

  For me, OT started during my stay at Methodist Hospital. The first goal of OT is to enable the patient to master the activities of daily living, from pissing and shitting all the way to managing money. My first personal goal was to avoid bedsores, so a nurse would help me sit up in bed for five minutes from time to time. By the time I got to HJD, I was more on the ‘using technology’ end of the spectrum. The day after my MRI, I was escorted to a room where a computer had been set up for the patients’ use. The PC sat on a plain desk, just in front of a wide, shelf-like structure that lined the window-facing wall and housed the air conditioning unit. I felt a shiver at the visual echo of my old cell on Park Avenue. Was this why I was working so hard to recover? To be able to sub in for a young banker on the Magic Roundabout treadmill to death when he went home in the wee small hours and needed his credit facilities drafted by his lawyer?

  Maybe, but I was cheered by the activity that had been prepared for me nonetheless. A kind of modified joystick had been clamped to the front edge of the desk; it was basically an unfinished block of wood. A thin, L-shaped piece of metal protruded by its foot from the front, and ended in a red, plastic gobstopper. The patient could rotate the lever around the axis of the base of the L. To have called it steampunk would have been generous. It didn’t exactly look like the sort of thing you could use to pilot the Millennium Falcon through the Kessel Run in twelve parsecs.

  I was instructed to manipulate a basic-looking cart through a black landscape on the screen to catch red, green, yellow and blue balloons of various sizes as they fell from the top of the screen. At the end of the session, I was promised more computer activity the next day.

  When the next day arrived, Sonoko appeared to take me to that day’s session. A woman of Japanese descent in her late twenties, her long, dark hair crowned a willowy frame that gave her the appearance of being taller than she was. She gained further stature from her all-business approach. That no-nonsense attitude was the reason I had decided she was not to be messed with. She was less a twenty-first century descendent of the curious Greeks than she was a modern medievalist, toting stern words instead of chains and restraints. I could understand this, given stroke’s propensity for precipitating perseveration, impulsiveness and bad temper. Something of the nurses’ manner with me would remind me that I was the legend who collapsed on top of his room-mate when he decided to pop to the toilet in the middle of the night despite his inability to walk, so it wasn’t surprising that my OT sessions at Rusk focused on thought experiments that encouraged good decision-making and flexible thinking.

  They would proceed along the following lines:

  Upon release from hospital after his stroke, Tommy is offered a job on a building site. The job involves carrying heavy loads up ladders, but Tommy is confident he can handle it. His wife is less sure. How should Tommy go about making his decision? What would you do in his position?

  How to handle chip pan fires was a topic that came up with amusing regularity. One of my inspirational Post-it notes even read, ‘Now you’ll be really good at putting out grease fires.’ I am a Scottish stroke patient, after all.

  Sonoko had something fun in mind for the day’s activities. ‘How are you with the internet?’ she asked.

  A window to the outside world that’s a full fourteen inches across? You’ve got my attention, Sonoko.

  She outlined what she had in mind. ‘What I want you to do is find a five-day vacation for two people. There are conditions, though. You’re limited to $1,000. The vacation has to be abroad. It’s got to take place in November. Also, the five days have to include a weekend. You’ve got an hour.’


  ‘I’m way ahead of you, Sonoko,’ I thought to myself.

  This was going to be a breeze. I knew a site that handled this sort of thing. I would just plug in the variables. I knew where I was going to go, and I knew who I was going to take.

  It was daydream time, and I was already standing with Beth in front of the Scottish Parliament. The abstract modernism of the parliament contrasted with the beautiful but staid Palace of Holyroodhouse across the road, which was all sixteenth and seventeenth century order standing against threats of fire, assassination and war. It was winter, and the granite of the parliament didn’t glisten the way it would in the architect’s Catalan home. The upturned boats of the Tower Buildings’ roofs were behind us. The hulls wouldn’t dry under a wet Scottish sun that hovers only an inch above the horizon. The vision stirred something in me, nonetheless. Enric Miralles’s amphitheatrical parliament campus emerged smoothly from the surrounding crags, embracing tradition while striding confidently into an optimistic future. This was where I wanted to go.

  This was going to be fun.

  My mind was racing down the corridor as Sonoko rolled me sedately along in my chair. I was desperate to get to work. I could see the computer room and the travel website in my mind’s eye, but even though we were there the previous day, I had no idea how to get there. I wouldn’t even have been able to tell you about the colours of these blue corridors if I hadn’t been presently passing through them. I’d been through them before, but I only existed in the moment. Unlike Miralles’s magnum opus, I had no link to yesterday. Sonoko got us to the desk, though, then left me to my work.

  ‘I’ll check on you in half an hour.’

  I started putting my plan into place. We could stay at the boutique hotel that looks out over North Bridge. Across from Calton Hill, where the upturned telescope of the Nelson Monument pushes into a sweeping white sky with the confidence of empire. The National Monument, Edinburgh’s Folly of twelve Parthenon pillars, hiding from view beside it. In the hotel, there would be overstuffed armchairs, tartan but contemporary, to cocoon Beth and I, warm and safe as we enjoy our cocktails that taste of peat and seaweed and smoke and sex.