Stroke

by Ricky Monahan Brown

  Even in the aftermath of his stroke, Alfonso was the picture of a spry, compact senior. His age weighed against an expansive upside, though. He wasn’t minded to tolerate the fussing whippersnappers of various ages, or throw himself wholeheartedly into some kind of Stroke Dance Revolution or cybernetic reinvention. He hadn’t been happy in HJD. As far as he was concerned, anything would have been better. Now that he was being released and would no longer be ‘treated like a bird!’ – one of his favourite, most incomprehensible complaints – he could let his fortress of fury subside a little.

  Rusk had been great for me, and I was continuing to make great strides in my physical recovery. My medical team had begun to talk with Beth about what apparatus I would need on my release. Top of the list, I would need my very own cane. Hearing this was yet another moment driving home like the pounding tools above that nothing would be quite the same again. I had gone to bed on 30th September as a young man. The next time I saw that bed, I would be a cane-carrying oldster. Fortunately, Beth was modifying the narrative for me. She took out the iPad and we browsed through pages of alternative walking sticks.

  ‘I can’t decide what I want,’ I told her as we leafed through the options on the screen. ‘I’m torn between supa dupa fly and Order of the Thistle.’

  ‘Like a swordstick?’ she asked. ‘I looked into that. They’re banned in a couple of states, and in a bunch of others they’re treated as concealed or disguised weapons. In Britain, you can’t even sell them unless they’re antique.’

  ‘Cool! I’d rather have an antique one, anyway.’ But we both knew a swordstick wouldn’t fly.

  As Beth continued, my disappointment was quickly forgotten. ‘Oh! I saw a good one!’ she told me, and brought up a picture on the iPad. This brass-handled cane would have been at home supporting Edwyn Collins at The Rock Shop. Easily. Its specifications indicated that the cane could support up to 250lb, while a typical person exerts no more than 100lb on their cane. Attractive as the stick was, this wasn’t even the main selling point. The top of the cane screwed off to reveal five thin, 2oz, hardened-glass flasks, or around six to eight shots of booze. How impossibly sophisticated!

  Soon enough, I took delivery of the actual cane I was to take home. It was a facsimile of the functional, unfabulous walking assistance instrument that Steph had been teaching me to use in physical therapy. When it arrived, an instructional leaflet swung from the handle, depicting a happy cripple of indeterminate gender in chinos, a pair of white sneakers and youthful old age. This undercut the trade name that was presented in a fashionable, caps-free, Ryan Gosling-evoking font that spoke of the existentially cool delivery of sex and violence – drive. Nevertheless, we somehow invested this symbol of my infirmity with youthful humour. Our pal Neal visited and directed me how to properly shake my new toy at the young uns who would have to ‘Get orff my lawn!’ He showed me the photo he took of me practicing, depicting a cartoonish curmudgeon. Scanning from head to toe, left to right along the bed, I saw an army crop that barely hid the holes in the head, a pair of sixties-era Michael Caine frames, a patchy, amateurishly shaved beard that outlined a face contorted in mock rage, and a left arm that held the stick and curled against a royal blue T-shirt clinging to a skinny core. Hospital tags had been pushed half-way up the forearm so they wouldn’t flap around. The picture was rounded off by a spindly right leg folded underneath the figure. There was a slogan on the royal blue T-shirt:

  KEEP CALM AND REVERSE THE POLARITY

  Doctor Who! The figure was me! I was pleasantly surprised to find that the shocking and ugly elements knitted together to form a guy who looked . . . OK. In a way. He certainly seemed to have a sense of humour about his situation. I thought I could grow to like him.

  Over the next couple of days, the other items that had been recommended to Beth and I from a short list of disability aids arrived, together with notice that their insurance-reduced costs had been applied to our credit card bill. They all bore that same sophisticated, modern script. The two grab bars for the shower. The lightweight wheelchair. Meanwhile, Steph’s cane-wielding lessons continued in the gym. As I learned to use it on the gym’s miniature staircase, I came to the conclusion that I either missed my old room-mate, or I was suffering from PTSD, because across the room, a guy with the same name as The Wee Man was taking instruction, and I was quite verklempt.

  I hadn’t seen much of Alfonso’s successor in Room 920. The curtain around his bed was pulled closed most of the time. When it wasn’t, I still had difficulty manoeuvring in bed in order to be able to see him. What I could piece together from scraps of conversation was that Bill Keller was in his eighties. Heavily-rotated discussions of urinary issues and the slurping of hot drinks confirmed the fact. Was this the future we were fighting so hard for? Well, not exactly. Still, the voice behind the curtain conveyed a vim that belied Bill’s years.

  ‘These young people who are looking after me really are very good,’ he told a visitor one day. ‘Very knowledgeable and enthusiastic.’

  Bill wasn’t ready to do much therapy out of his bed yet, so his occupational therapist came to him.

  ‘What would you like to focus on, Mr Keller?’ she asked.

  ‘I’d like to be able to return to work when I’m finished here.’

  In his eighties! Good for you, Bill! Or not. I wasn’t sure anymore.

  He explained to his therapist that he intended to resume his business as an investment adviser once he had recovered from the brain surgery and resulting complications that had occasioned his stay in HJD. He was concerned that the trouble he was having with writing would make this difficult.

  ‘OK, Mr Keller. Here’s a pen and a pad. Can you write a sentence for me?’

  Bill complied, and the therapist read the result

  ‘ “I love Paula.” That’s lovely. And who is Paula?’

  Paula was Bill’s second wife. He adored her, and it became clear she loved him, too. Paula was in HJD with a frequency that rivalled Beth’s, often with friends and family in tow. While we discussed ‘What Bling Cane Would Biggie Choose,’ the conversations behind the Kellers’ curtain reflected the more mature concerns of the sort of people who split their time between Manhattan’s well-to-do Upper East Side and the privileged enclaves of Westchester County. The latest books receiving coverage in the New York Times. The economy and property prices. Renovations to apartments and summer homes. Also, in the aftermath of Hurricane Sandy, yard clean-up.

  Paula and Bill’s friend Joyce, a lady of stentorian tone and similar vintage to the Kellers, had strident views on this last topic and the failings of a ne’er-do-well nephew or neighbour or neighbour’s nephew called Hank. ‘I mean!’ she exclaimed in an exasperated tone, ‘Two weeks have passed, and that damned tree is still lying in his front yard.’

  ‘Really?’ Paula responded. ‘We just had our tree guy come and take care of ours. Would you like us to pass along his number?’

  Not previously having been aware of the seriousness of these issues, I fixed Beth with a concerned look. I had a terrible admission to make. So grim, it could only be whispered in the shadows of Joyce’s booming condemnations. ‘I don’t even have a tree guy.’

  The mockery was affectionate though, and when Paula emerged from behind the divider to offer the remains of the pumpkin pie and cream Joyce had brought, we cheerfully accepted. A companionable, chewing silence fell over a room filled with late autumn light and the spicy fragrance of the pie.

  Bill was still an octogenarian, though. The next day, having delivered and tidied away my laundry, massaged my left hand, and tended my febrile mind, Beth was getting ready to leave and take the subway back to Brooklyn when Bill said, ‘Excuse me, young lady. Would you call the nurse for me?’

  Like Alfonso, Bill had led a life in which tasks not directly related to salary were attended to by a convenient helpmate. If Paula was absent, my partner would have to do. Tired by the demands of the past six weeks and distracted by the flesh collapsing into the voi
d left by Bill’s absent mass of skull bone, Beth didn’t mention the call button hanging from Bill’s bed, but dutifully retrieved another woman from the hallway. Then she dashed back into the room to bid me farewell before she made her escape.

  Meanwhile, the preparations for my release continued. Notwithstanding the cane selection process, it was a serious business. At the time, I didn’t register the depth of my carers’ concerns, only the kindness of that concern. If we hadn’t lived in a single-storey apartment in an elevator building, if Beth hadn’t been able to take a month off work to make sure I didn’t ignite fat fires, I would have been transferred to the step-down facility with Alfonso. Nevertheless, progress was good.

  A week previously, in the first of two Saturday PT sessions, Steph had re-administered a STREAM test, or STroke REhabilitation Assessment of Movement. This involved a repetition of certain of thirty tasks that I was told had been measured soon after my arrival at Rusk. Over twenty minutes, I was asked to perform movements spread among upper-limb movements, lower limb movements and basic mobility actions. Steph compared the range and success of my movements to the results of the original test, and declared herself happy with my progress.

  Things went well enough that when I expressed my jealousy of the older lady on my left, who was being encouraged to mimic what her therapist called a ‘soccer’ player, despite her evident distrust of such commie bullshit, Steph promised me a football in our next session.

  The fifteenth of November was a red-letter day. I got to push a football around with my left foot. Steph declared that we were down to fine-tuning my cane-assisted walking on the same day that Bioness, the maker of my favourite cyber-conversion tools, followed me on Twitter. Around the same time, another alert popped up on my phone. It probably wasn’t to be advised, but it was tempting. Groupon.com wanted me to sign up for a four-hour BMW 328i reservation to celebrate my release. I mean, it was only a little tempting – my occupational therapists and nurses had taught me well – but I welcomed the feeling of tantalisation. ‘I’m alive, you bastards!’ I thought.

  Dawn brought round some more CDs that offered guided relaxation and ambient sounds that I could take home. One promised ‘no jarring tempo changes or unexpected interruptions’. I was grateful, even as I told Dawn that jarring tempo changes were exactly the sort of thing I liked. Although I had an improving sense of time, and the days no longer disappeared the way they so recently had, they still airily evaporated as we accelerated towards my discharge. Towards deliverance.

  On 19th November, there was a big event. Joe paid a visit with his partner Claudia later in the day, and I told them all about it. Effortlessly handsome and successful, they were still happy to step out of a Ralph Lauren advert to visit a sick pal, and I was enjoying their visit.

  ‘Beth brought my going home pants this morning!’

  I happily brandished a pair of boxer briefs in Beth’s favourite colour. Joe snorted.

  ‘The best part about forgetting you’re Scottish is that your definition of “pants” is the funny one.’

  After they left, I embarked upon a marathon physical therapy session with Michelle in charge. We started with a pair of light dumb-bells. Their purpose was to encourage concentration and form, I think, because my left arm already felt like it weighed a tonne. Nevertheless, it was exciting to be doing something new. Something that regular folks did.

  I finished the set, and my therapist dropped the encouraging chatter for a moment to resume our conversation. ‘So, you’re leaving us tomorrow?’

  ‘The day after, actually. Just in time for Thanksgiving.’

  The holiday was rapidly approaching and today, Monday, was my last inpatient PT session.

  ‘OK,’ Michelle said. ‘Do you want to go outside?’

  Did I ever! A shiver of Stockholm syndrome whistled through my skinny scaffold, but was blown out by the thought of being able to report my exploits to Beth later that evening. Michelle and I stopped briefly at Room 920 so I could put more clothes on, then I sticked my way down the now familiar corridor to the elevator bank while she blocked for me. It took forever for the lift to come. I was so close to being outside – properly this time – but still. The waiting.

  Bing!

  We commiserated briefly with our fellow inmates and wardens about the time we had to spend waiting to move between floors, and I was reminded of one of the truths of a long hospital stay: eventually, you’re going to find yourself chatting with someone redolent of that particular smell of ammonia. In HJD, this was all the more marked because we would forget to drink or couldn’t be bothered to drink or couldn’t reach our water glasses or lift our jugs. For all these reasons, our urine was more concentrated, pungent.

  Eventually, we were able to vacate the elevator. I was dressed for the outside, but still surprised by the actual, physical wind invading the lobby. A season had passed me by, but when we passed through the doors – thin, momentous sheets of glass – it was confirmed. Winter was rushing in.

  The sky was blue, though, so when Michelle asked how far I thought I could manage, we decided to walk south down Second Avenue where it bisected Stuyvesant Square park, surrounded by nature in the Flatiron District. In my excitement, I forgot how to negotiate the stairs outside the lobby with a stick.

  ‘Stop and think about that for a second, Ricky.’

  My stride had the yips, and I couldn’t quite figure out what to do next. Michelle gave me time to figure it out for myself. Standing at the top of the steps, I really had no idea. All I could figure out was that I must have been doing something the wrong way round. In the excitement of being outside, I was trying to start with my cane, then my strong leg, then the weak leg. That’s the technique I made the effort to burn into my mind for stairs. Climbing stairs. The steps outside the huge glassy panes descended from the concrete expanse to the pavement. I was doing everything the wrong way round. I gingerly laid my left hand on the handrail. Because of the damage to my brain, it didn’t register the steely chill.

  My more functional right arm reached out and extended the triangular foot of the cane down onto the step way below. Positioning my weight squarely over my right leg, I let my other leg slap onto the stair before readjusting and following with the stronger leg. Once again, I recalibrated.

  My right arm reached out again and extended the triangular foot of the cane down onto the second step. Positioning my weight squarely over my right leg, I let my other leg slap onto the stair before readjusting and following with the stronger leg. Once again, I recalibrated.

  One more. It was beginning to feel natural. Was that a good thing? My right arm reached out and extended the triangular foot of the cane down onto the sidewalk level. Positioning my weight squarely over my right leg, I let my other leg slap onto the pavement before readjusting and following with the stronger leg. Once again, I recalibrated and tried to figure out what was next. Looking past the MRI truck, a steady stream of traffic was flowing along 17th Street.

  Michelle and I made our way to the crosswalk at the corner and I managed a further block before we had to turn back. I wouldn’t be doing a lot of walking any time soon. This was another cold blast of reality, but my optimism hadn’t been dulled by my final inpatient PT session. We retraced our steps and I shuffled back up the steps. Up the elevator again, and as we approached Room 920, Michelle suggested that we finish our session at the gym. It was quiet now. Steph and Rodney were chatting, as if passing the time while waiting for someone.

  ‘Hi, Ricky! You’ve been busy! You looking forward to going home?’

  ‘I can’t wait!’

  ‘Right. Well, we’d better get your picture for the Hall of Fame, then.’

  Now I really was ready to go home. In the picture with my therapists that adorns the gym, my smile still looks a little lop-sided, if you know what you’re looking for. It’s real, though, and I appear trim and fit and, after over fifty-two excruciating daily stomach injections, more than ready to go home.

  Of course, th
e camera sometimes lies.

  At 6a.m. on 21st November, Tenko dragged me out of bed for my shower. When speech therapy started at 10, I was already bushed. It didn’t matter, though. Liat’s visit to my bedside was mostly social, filling in the time until Beth would arrive to take me home. My partner, the subway nerd, knew that negotiating the streets to the Third Avenue subway station, with its crowds and turnstiles, then barrelling along on the L to Lorimer Street in Brooklyn before walking to Metropolitan Avenue to change to the G was desperately ambitious. The G was a locomotive disaster, even for the able-bodied and right-minded. It was the only non-shuttle service in the MTA system that didn’t run through Manhattan and as such, had to cede precedence to its cousin, the F. Even at rush hour, the G was only scheduled to run every ten, or even twelve minutes. It would only take a minor delay, then Beth would be looking after a newly released stroke patient on a crowded platform for quarter of an hour.

  Stuff had been happening during my confinement. Not just Hurricane Sandy and a presidential election. The Uber car service had been getting some traction in New York. Having had access to my law firm’s car services until immediately before my stroke, we had never had call to call them, but our tech-minded MBA-toting friends loved the tech-utilising venture-funded start-up.

  This was how we found ourselves sitting in the lobby of HJD, peering at Beth’s iPhone. We were meant to be able to watch the car on the map on the phone as it made its way to us. What we were actually watching was a static dot, and our excitement was waning. Thirty minutes after the appointed hour, Beth managed to connect with our driver and explain our situation.

  So it was that, over an hour late, I was using my Sonoko-taught method for getting into a car. I got as close to the passenger doorway as possible, and sat down, perpendicular to the sidewalk, before swinging my legs into our ride. Then we sat in traffic for another hour and a half.

  In the end, we weren’t happy to get to our apartment, just exhausted. I suppose we should have been glad to get home at all. Around that time, the city admitted that almost a third of the nineteen thousand lane miles of road that covered the five boroughs of New York City and conveyed cars like misfiring neurons jerking and halting through sticky streets were substandard. But still, almost three million cars would scramble across forty-seven structurally deficient bridges rated ‘fracture critical’. We could have tried to take that G train, but more than a third of the mainline signals had exceeded their useful life. Maintenance workers would build their own replacement parts, because after more than fifty years, manufacturers no longer made them.