Without therapy, and my inpatient therapy log, I didn’t remember that I couldn’t even raise my arm above my waist a month ago. So, as requested, I stood steady in a variety of poses with my eyes open, then closed. I walked a few yards, picking up items strategically left on the floor. I showed off my uncanny ability to get in the shower and sit on, and get up off, the toilet. I got onto the bed and rolled over.
‘Like,’ I could imagine Alfonso saying, ‘a dog.’
Ranjan and I hit the internal fire stairs and I demonstrated my ability to get up and down a flight of steps, only being slightly thrown off by the fact that, unlike hospitals, regular buildings only have a handrail on one side. As soon as I had negotiated maybe my fifth set of stairs in two months, we headed back to the flat to take a blood pressure reading. It had spiked a bit, but still, I was in a good mood. My competitive inner child was doing cartwheels, the show off.
When we finished the session, Ranjan pronounced himself satisfied with what he had seen, and asked what my aims were for outpatient PT. I told him, with Beth – my real audience, sitting a few feet away, that I wanted to get back to normal, pre-stroke, 100 per cent functionality. He said he reckoned that was reasonable, which suggested to me that he hadn’t read my records. Then he outlined his expectations regarding a couple of weeks of home PT prior to sending me to Rusk Midtown, and we had a quick chat about setting up Access-a-Ride, the city’s paratransit service, for the trips. I got a copy of Ranjan’s business card, including the VNS main office details so I could address that with the head nurse for my case.
Then it was right back to regular strokiness. Within ten minutes of Ranjan’s departure, I had no idea where the business card was. Still, I had been using the most useful piece of advice I got in speech therapy (memory section) and was keeping all the new information I might need in my phone, so the physical therapist’s personal details had already been added prior to business card loss. I called him and got the additional details for the main office. ‘Yay for the positive results of therapy!’ I thought.
It was agreed with the VNS that another step on the path to normality would be reinstating my daughter’s visits. These were quite limited at first, because in a New York neighbourhood where kids were ferried from gym class to power tools camp to the tennis courts to a wacky science educator before lunch, stroke survivors were boring.
Nevertheless, in anticipation of this new normal, Linda popped round to see how I was doing. She brought a decaf coffee and a pastry for each of us, and sat down at our little black dinner table that teetered on spindly little iron legs. She told me I was looking well, and that she was glad I was home. After some brief questions regarding my current welfare, counsel moved on to more substantive matters. For the first time, I coherently formed an awareness of watching my brain from a third-person remove. I didn’t want to say anything stupid. Make any incorrect plans. Give up anything that might have been taken down and used in evidence against me. Yet I was still keenly aware of what was later diagnosed as the ravaging of my processing speed. Around half of people think that memory works like a video recorder. If that’s the case, my measurable decline in processing speed was like capturing images at a rate of a frame every thirty seconds through a scratched and scarred lens. Not only was my damaged brain doing a hobbled sprint to keep up with the conversation, it was doubling its workload as it sat on its own shoulder, monitoring.
‘There’s no way I’m going to remember any of this. Do you mind if I take some notes?’ I asked.
‘Oh, I’m not going to get into much. You won’t need to do that.’
You have no idea.
Within twenty seconds, I was flailing and had to ask again. After acceding to my request, Linda completed her information dump with all due haste and headed to work.
That evening, Beth got home from work and asked how the meeting went.
‘Er, quite well, I think? She started off all sweetness and light. Something about how I’d reverted to the nice guy she’d met back in the late nineties. I think that was meant to be a compliment about how my base personality is actually quite pleasant. I’m not sure how I’m meant to feel about my brain-damaged, reliant, subjugated self being so much preferable to the hateful, functional me! After that, it was all business. She’s got some ideas about when we can look after Elizabeth. Let me get my notes.’
I made a hobbling round trip to the kitchen table, returning with paper in hand. I sat down, and started reciting the notes with increasing horror. My handwriting wasn’t that good before the stroke. After winning the school handwriting prize for primary four when I was nine, my script had been assaulted by years of legal study and practice. Now, the spindly, crippled scrawl of my left hand was truly illegible. The words I could painfully decipher didn’t trigger any recollections.
Beth called Linda to let her know that we hadn’t been able to assemble the content of the conversation. They agreed that Elizabeth would have a quick visit on Wednesday evening, and Beth told Linda her that if there were any arrangements to be made, it would be best if she sent an email, or Beth was present at the time.
Elizabeth began to spend Wednesday evenings and half a weekend day with Beth and me, as we started building up visitation again. Despite her tendency to anxiety in the face of less serious issues, Elizabeth showed the same resilience in the face of my stroke that she had displayed when the permanence of her parents’ separation became clear. She took on additional small chores without complaint, and was more receptive to instruction while I was still clearly damaged and the dark days of autumn were fresh in everyone’s minds.
During one visit, I asked her about what differences she had noticed having a Stroke Dad. Not too much, she told me, though she did feel she was having to take on a little more responsibility.
‘I’m reading a new book,’ Elizabeth told me. She was a voracious reader. ‘It’s called The Book of Blood and Shadow. It’s about this high schooler, Nora, and she’s doing work for The Hoff. The Hoff’s a professor, and he has a stroke. She spends a bunch of time visiting him in hospital.’
‘Really? Does the author get down what it’s like?’
‘Yeah, it’s pretty well done.’
‘Cool,’ I told her, and added a request. ‘You know those Doctor Who Post-it notes I got you? Can you flag the pages that are set in the hospital for me?’
I wanted to get some insight into how she perceived things had gone down. It was a good visit, and before my excitement waned and I tired too much, Elizabeth’s mother arrived with the babysitter to pick her up.
When they had all left, Beth and I sank into our big orange sofa. ‘You’d better take your blood pressure,’ she said.
I slid the cuff over my right bicep, and rested my lower arm on the armrest. I took three deep breaths and pressed the button on my home blood pressure monitor. 171/112mmHg. That wasn’t good.
After lying together in the dark for a while – no funny stuff – we decided that it was best to distract me from my perseveration. Tomorrow would be a new day, and while Beth went across the street to do a yoga class, I was to take on A Big Project. Sorting out winter clothes, random clothing rearrangement and screwing a fancy modern-design hook to the wall for hanging scarves. There were to be no falls or driving screws through my hand. Resurrection was one thing, but we had to draw a line.
Going into any new task, I was finding that one of the hardest things was modulating my expectations. Walking to Methodist Hospital from 15th Street? No problem. Manoeuvring along a single row of seats to see the Brooklyn Nets play at the Barclays Center? Utterly nerve-wracking.
On top of that, my self-perception was a mess. A couple of months post-stroke, I had already normalised the time when I was still clearly broken, and any task completed was a clear triumph. In my head full of pink goo, I thought that I was coming to resemble Ricky Brown again, and tasks that couldn’t be completed in the style of pre-stroke Ricky felt like defeats.
Beth knew better though, and before she
headed across the road to the YMCA the following afternoon, she talked me through the project again. I kind of got it by the third go-through, and after she left, I ran through it in my head again, and got started.
The initial problem was simply getting my body into position to organise the stuff that needed organisation. The refrain of October – ‘Why is there always something hard pressing against my left side in an agonising fashion?’ – had now been replaced by ‘Why is everything always below waist level?’ All the adjustments I had been making to compensate for my weak left leg, including weeks of hyperextending that knee, had left my body complaining about bending over and crouching. I had even been moved to raise this with Ranjan. His response was encouraging: the hyperextension should ease off, he said, when my leg muscles were stronger, and moving to outpatient rehab in Midtown where they had weight machines and the like would probably help with that.
Nonetheless, the clothes sorting was tortuous until, eventually, I had done what I could, and I moved on to hook hanging. I didn’t make this easy for myself, but instead followed my usual routine, utilising spirit levels, support plugs, electric drills, a pencil and so on. This went swimmingly, although holding a pencil, a screw and a plug in my claw-like left hand simultaneously did lead to a couple of drops. All in all, I didn’t feel too bad. I was using a power tool like I was a grown man, damnit!
I still had to admit that I had spent the evening working at the limits of my organisational, physical and anxietal limits. Anxietal wasn’t even a word, to boot. I was glad when time came for me to press ‘send’ on the Chinese food order Beth had set up on her computer before she left, and settled down to await her return. I was a little bit emotionally on-edge. However, when Beth got home, she was able to calm me in short order: I had done a good job, look how far I had come, etc.
When we had got ourselves together, we watched the James Bond movie Skyfall, which had been on our list of things to do for a while. After my You Only Live Twice Thanksgiving shower, I was in the mood for some Bond. It was good, but not the best Bond ever I’d been led to expect by the reviews. Then the film took an interesting turn.
Beth was the first one to be affected by the sight of Glen Coe, in all its terrible, haunted beauty. Once she was off, however, I was away too, as I realised how close I’d come to never seeing the beautiful country of my birth again. Yes, my lights would have switched off too quickly for me to even be aware of the loss. But, y’know, Scotland, man. It was good to be alive, and have Glencoe, Calton Hill and the Moray coast.
Because, you know what? Everything was below waist level, but everything was OK.
15
Never Enough
At least, that’s how things seemed at the end of November. By the time we spent Christmas Day at Paul and Jen’s, everything felt a little different. Like many stroke survivors, I was still grappling with emotional lability or, as it’s also charmingly known, emotional incontinence. It was still hard to shake the dark thoughts that clustered in my mind, but from the inside, this seemed entirely reasonable.
Whenever Beth ran an errand and I was left to my own devices, I couldn’t stop thinking that the day when her sense of obligation to her disabled boyfriend would run out must have been approaching. In my mind, the endless work she had done since the night of The Event suddenly wasn’t evidence of the strength of Our Thing. It was, rather, filling a finite bucket of love that must surely have to be emptied sooner or later. Then what would I do? Trying to find a new job in the post-financial crisis world had been bad enough when I could – I thought – pull an endless succession of all-nighters and close billion-dollar deals. Without Beth’s help, I would be left to run through my savings in short order and sit at home mourning my latest and worst loss.
Jen reminded me that feeling down at this time of year was far from unusual.
‘I mean, it’s not like for you guys,’ she said, ‘but I feel like we’ve had a pretty hard end to the year. The holiday season is stressful enough – we’ve been scrambling around, dealing with deadlines, over-scheduled evenings and weekends, extra shopping – but now Mom and Dad aren’t doing so great. There was the hurricane, of course.
‘Then there was Sandy Hook.’
On the morning of Friday, 14th December, a young man in Connecticut had killed his mother at their home before driving to Sandy Hook Elementary School and shooting twenty six- and seven-year-old pupils and six more adults, then turning the gun on himself. Although Jill’s school in Brooklyn had been really good with the kids, Jen was struggling with it.
‘Everyone’s struggling with it,’ she continued. ‘Here in the metropolitan area, people are already disproportionately stressed about their personal health and job stability.’
Tell me about it, I thought.
When Beth was home, things weren’t so bad. She knew the things to say to calm me, and her voice was as soothing as ever. We would sit together and watch holiday television. Easy-going stuff, like those list shows of Twenty Best Things of a Thing Ever that they show on BBC America.
One evening, we tuned into a programme called The Brit List. This particular episode listed the 20 Sexiest Brits.
‘You know,’ Beth said, ‘I like skinny British men in their middle age—’
‘I’ve told you, we’re calling it the Early Clooneys!’
‘Whatever. Have you noticed that they’ve had to fill this out with a car? And a candy bar!’
Certainly, we were beginning to feel our way into a new normal. For the moment, Beth was working from home. I would spend the mornings working through a battery of simple exercises and tasks around the flat before preparing lunch, doing the dishes and setting to work on some random computer project that would take infinitely longer than anticipated – on this particular day, it had been trying to get a telephone calling card to Scotland. Then it was time for a quick walk to the pharmacy. Beth chummed me along as we tried to get a refund to account for not having had her insurance card with us when we first picked up my latest prescription. The weather was unseasonably balmy, the sun was out, and – bonus – I was feeling steady enough to pick up my stick and hold hands as we strolled through the Windsor Terrace neighbourhood of Brooklyn, just across the Park Slope border. Beth didn’t have her debit card with her, so they couldn’t issue the refund, but we had a nice old time regardless, chatting not unlike the way we always had on the balcony or on the fire escape stairs at her old apartment in Crown Heights.
When we got back to the flat, the nursing service had changed tactics. Now, the ambush was combined with a pincer attack. After a long wait, my visiting speech therapist was finally ready and approved to visit, and my occupational therapist was also ready for her latest pop-in. They were both trying to schedule a visit for the same time, naturally. I suggested they put their heads together, so I didn’t have to do something dangerous, like swallow and put out a grease fire at the same time. Speech won. The speech therapist turned up in the late-afternoon.
What is it with speech therapists? I wondered. They’re all lovely. It must be some sort of quantity theory of niceness. Or maybe at the dawn of time, they nicked all the humanity from the occupational therapists.
Beth headed back to work, and Mary – a jolly woman in early middle age – suggested that we begin with a reading test. She asked me to pick a book at random from the bookshelf. That wasn’t wholly advisable, so I slid past Trainspotting and Alasdair Gray, and James Kelman’s Booker-winning swearfest to Chris Brookmyre’s Quite Ugly One Morning.
‘That looks interesting,’ Mary said. ‘Can you read me the first page?’
‘Are you sure about that?’ I asked, and pointed out the opening words: ‘Jesus Fuck.’
We managed to find a passage that was a little more PG-rated, and I skipped through a page or so to Mary’s satisfaction. When that was done, she looked around and identified the toys overhead as Doctor Who memorabilia. William, Patrick, Jon, Tom, Peter, Colin, Sylvester, Paul, Christopher, David and Matt were all lined up a
round a scaled TARDIS that hovered on a shelf above the big orange couch.
I decided that I liked Mary.
‘Well, I don’t think you’re experiencing any difficulties with your speech.’ She smiled kindly when I finally paused for breath, about thirty minutes into an exhaustive monologue regarding the intricacies of the continuity of the show (1963–89, 1996 and 2005–12). I had passed my speech and memory evaluation, even if I had forgotten to remind her to call in to the office at the time she asked.
‘The VNS is really just concerned that patients can function at home,’ Mary told me. Pleased to welcome the world back into the flat, I could go beyond that and talk the hind legs off any poor soul that cared to swing by Monahan-Brown Towers.
I’d gotten the hang of the walking stick, too, and Beth and I would take short walks with no particular destination in mind. These walks were pleasant – we could chat easily as the novelty of being outside together on a crisp New York winter’s day distracted us from weightier issues. Then, building on the pharmacy visit, our expeditions began to have goals. One pleasant Friday afternoon between Christmas and New Year, we struck off towards Methodist Hospital for me to get an angiography. It was a ten-minute walk, so we budgeted for forty.
Since Beth had first told me about her visit to the aneurysm awareness group, we had made it to a meeting together and I had discovered from my fellow attendees that suffering a ruptured aneurysm is quite similar to going through a haemorrhagic stroke. It tended to involve getting wheeled into an ER, unresponsive, late on a weekend evening, with potentially catastrophic results. Generally, it was something best avoided.
Doctor Ayad had explained that it was best to get as much good information about my aneurysms as possible. How big were they? Were they smooth or knobbly? Where were they, exactly? So he had signed me up for this angiography, an imaging of the blood vessels in my brain.
Stroke Page 15
