As Beth and I walked and shuffled along, respectively, the tree-lined avenues of Park Slope suggested a classical Elysium dropped into a Victorian patchwork of stoops, bay windows and finials. I was a tested hero, selected by the gods to be rewarded with a blessed and happy life among Pindar’s splendid trees, borne along by Plutarch’s soft winds. Or something.
Then we arrived at Methodist, and I was plunged back into the stroke patient’s Kafkaesque world. This time, I didn’t register the gentle, considerate ramp that catered to the patients and the Park Slope. This time, the main entrance looked like a scene from M.C. Escher’s Relativity, with stairs and pathways entering and disappearing from my field of vision at random. It was all very airy and modern. Eventually we found the bi-plane intervention area indicated by the appointment letter which, disappointingly, did not have a Sopwith Camel hanging from the ceiling.
After not too long a wait, we were called into a small examination room. I was quite happy that, as a little blood was taken, just the right amount spattered across the cold, speckled grey linoleum floor to appear dramatic crime-sceney, but not enough to swim in. Job done, the nurse departed, and after Beth and I had had a chance to sit together for a bit, I was wheeled into a low-key operating room.
In his usual, calming fashion, Dr Ayad explained that the contrast dye I was being injected with would cause a warming sensation, like I had wet myself.
‘You might experience some minor discomfort, as we begin the procedure,’ he continued. ‘That’s usual.’
He didn’t mention that there’s a scene in The Exorcist in which Regan MacNeil gets a carotid (or neck) angiogram, and according to director William Friedkin, this angiography sequence was the scene in the film most likely to upset audiences.
Entertainingly, The Cure’s ‘Never Enough’ pulsated through the OR as my procedure proceeded. I thought to myself, ‘Why not throw on Joy Division’s desolate “Unknown Pleasures” to really get us all in the mood?’ My amusement was doubled when I looked up the lyrics afterwards. Someone in Methodist Hospital had a wicked sense of humour, because the chorus of ‘Never Enough’ kind of described my procedure. Go on, look them up. I’ll wait . . .
While Robert Smith moaned away, the miniaturised equivalent of a camera on the end of a pipe cleaner was pushed into an incision in my groin and through a passage of blood vessels up into my brain. Now, I would encourage everyone to take any angiogram that is recommended to them, since it’s not horrible and you’ll feel fine a day later. It was about as comfortable as that sounds, though. Groin-wise, at least. The other warning Dr Ayad had given me before the examination was about the hard, marbled-sized bit of scar tissue that would be left just above my groin. On the plus side, that would dissipate soon enough, and the drugs – Valium and Versed – were pretty good, to the extent that there was little remaining nausea when everything was done.
Appropriately, given the soundtrack, the results turned out to be like a grey, British shower: depressing or reassuring, depending on your mood. The best-case scenario would have been a single aneurysm, treatable by coiling. The fact of my two aneurysms was confirmed, but in the short time since the work-ups that had been performed in the aftermath of my stroke, they had remained stable and relatively small. The initial diagnosis, though, was that coiling was out, because the aneurysms were situated at junctions of blood vessels, and the wire mesh and any associated stent might have blocked the flow of blood. The hope was that we could approach them with a watching brief and treat them by clipping at an applicable juncture. This approach had its advantages: first, it would prevent blood from entering into the aneurysm sac at all, so that it could no longer pose a risk for bleeding; and, second, it would cause the aneurysm to shrink and scar down permanently after the clipping.
On the other hand, it would still be brain surgery, with all the attendant risks. Still being in recovery mode, I wasn’t ready for that yet.
In attending our aneurysm awareness meetings, Beth and I discovered that each of the survivors of a brain haemorrhage has a story about his or her experience that has been practiced many times. Each catalogue of disaster had been turned into a sort of narrative. I suppose that a kind of Brechtian distancing effect is needed in order for the survivors to be able to discuss the events and results of a brain haemorrhage. Otherwise, it’s all a bit, ‘Yeah, so after they removed the catheter, I started learning how to walk again . . .’ That’s borderline depressing.
On the other hand, one of the haemorrhage survivors was keen to find out if she could somehow rebuild accurate memories of her haemorrhage and its near aftermath
Dr Ayad expressed some surprise at this. ‘How many of you would actually want to remember what happened?’
All the blood and shit and piss and fear and uncertainty and pain?
‘I would,’ one of the group replied.
Dr Ayad looked around the room, and the raised hands indicated a roughly two-to-one split in favour of knowing.
‘There seems to be a gender divide,’ he noted. The men in the room were relatively incurious in this regard. The women, as well as myself, wanted a clearer recollection of what had happened to them. There was, it seemed to me, a way to do this. If you talk about The Incident and The Aftermath often enough and with enough people who were there, the repeated details build something akin to a memory. It’s like that childhood recollection where you’re not sure if you actually remember the experience, or just the details practiced in telling the story or hearing your parents repeat it. In any event, it did seem that the aneurysts wanted an understanding of what had happened to them. They had a very human desire for meaning behind the inexplicable. After all, what was the point of having a catastrophic brain haemorrhage if you weren’t going to take something from it?
I decided to start attending a creative writing workshop a short distance north of Park Slope, in the back of a bookshop-cum-art gallery-cum-gift shop in Boerum Hill called Grumpy Bert. Like me, like everyone, the woman who led it was a different person to the one she was born as. In her case, when she was an infant, she had been flown from South Korea to Philadelphia to be adopted by her white, single, American mother.
The workshop was comfortable and supportive and smelled of hazelnut coffee and brownies. It was filled with a small group of people trying to find their writing and themselves. When we were set twenty minutes to write, I began writing the origin story of the guy who died and came back to life beginning on a rainy day in Flushing Meadows, Queens.
It had been a strange last quarter of the year, and there was still Hogmanay to get through. Since New Year’s Eve was traditionally the biggest holiday of the year in Scotland, it was the time that I missed home the most. The Celtic emotion would burst from a facade of Aberdeen-sourced granite and I would weep for Glencoe and my family and friends and my late mother and grandfather, and all that I’d left behind. Yet for all the tears that had been spilled recently, it was hard not to approach this quiet New Year, seen in in our little apartment, as the gift that the root of the word Hogmanay would suggest. As Ryan Seacrest on the telly counted us down to the dropping of the Waterford Crystal time ball in Times Square, Beth and I rose from the sofa and held our champagne glasses and each other.
‘Happy New Year, Baby. Thanks for everything. I love you. You’re the love of my life.’
‘I love you. Happy New Year. We got through it!’
It was a new year and a new life, and I was feeling . . . good?
My brain watched itself for a second. Yes. Good.
As we entered the new year, life began to take on a less institutional rhythm, as Beth continued to work from home, fitting in short walks around the neighbourhood with me. Physical therapists and visiting nurses and faltering attempts to figure out the story of what had happened since the end of September kept me out of her hair while she did her work.
Finally, after the worries about the numbness in my left eye, I made it to the optician around the corner. I was concerned about how things w
ould go. Would the stroke have wreaked unnoticed havoc with that eye? Would the capillaries at the back of the eye have burst, or narrowed or thickened as a result of years of high blood pressure?
The doctor did that test involving the pupil-dilating drops, then checked out the capillaries with the magnifying lenses in one of those ophthalmoscopes they use to look at the structures behind the pupil. It’s a good test, because this is where these small blood vessels can be viewed and often any problems here are likely to be repeated in small blood vessels in places in the body that can’t be seen, such as in the kidneys. Fortunately, the test didn’t show up anything bad, and my prescription was largely unchanged from my previous check-up some time during the Mesozoic era.
After these sorts of little unsupervised trips, and now that I had made it out to a couple of workshops, Beth and I became more ambitious. I put on a tie and a now loose-fitting suit, and returned to Grumpy Bert to share a few words on the subject of being ‘Lost’ together with twenty other workshop participants. I talked about how, four months previously, I had lost my youth, my job, my short-term memory, the ability to walk and the feeling on my left-hand side. I was learning to build my own narrative of what had happened to me.
Soon after this, Beth and I headed out to JFK airport for a flight to Los Angeles. It hadn’t been so long ago that we were sitting in HJD discussing whether we should cancel our flights and reservations to the annual Doctor Who convention that we had been to in each of the previous two years. By the time we were ready to set off for LA, I was unreservedly looking forward to it, and to catching up with friends.
It turned out, however, to be a very New York departure. Getting out to JFK by public transport wasn’t the quickest thing, and we missed our initial flight. In the rush, I even managed to leave my laptop at security. Good for the folks at the airline and in security, though: they got it back to me as soon as I noticed it was missing.
The flight itself was sold out and filled with airplane clichés. The seat right next to me was filled, and more, by a huge fella. My left side complained whenever he brushed against me. Of course, there was a baby nearby who screamed the whole way from New York to LA. When I peeled myself from my seat at the end of the flight, I could understand why Beth’s mother had asked whether I was approved to take a cross-country flight.
In the end, though, it was all worth it. We got to see old friends and meet new ones. The discussion panels were good, too. But recovery is not a smooth story. I was exhausted when we got home, and Beth became concerned that, shortly after falling asleep at night and waking up in the mornings, I was having fits. For some weeks, I had occasionally been feeling a tension in my left leg, and if I flexed in the right way, I could generate a good old shake. A coughing fit would generate a similar response in my left arm. Although Beth was familiar with the leg and arm shake, these night-time fits were still quite disturbing.
Over four months after my stroke, I was still experiencing new symptoms. I would also feel tingling sensations sometimes in my left arm and, occasionally, leg. These seemed to be good signs that sensation was returning.
One day, back in Brooklyn, we ventured out to visit Paul and Jen without the aid of a car service, but it was hard going. Towards the beginning of the trip, I was breathless. When we arrived at the Waterfront District, I was quietly gasping for breath, trying not to make too much fuss. You would think I would have learned my lesson. We got through lunch and the beginning of a pleasant afternoon, but eventually we had to cut the visit short and order a cab.
When we got home, I lay on the big orange sofa and tried to relax.
‘Take deep breaths, Honey,’ Beth insisted. ‘You control it. Don’t let it control you.’
I tried to reply, but my lungs were wooden, rheumatic and stiff, only allowing one word to escape at a time. Seven weeks of superhuman effort, and here we were again.
I wanted to be OK. I didn’t want to die again. I wanted to stay here with Beth’s warm, life-giving hand on my chest. I didn’t want this to be the rest of my life.
‘I . . .’ I gasped. ‘. . . think . . .’
Another few gasps, then another word. ‘. . . we . . .’
Soon, I lost track of how far through the sentence we were. I spat out the next two words quickly, breathlessly: ‘. . . need to . . .’
Jesus. How long was this going to take? I tried to fill my empty, collapsing chest with enough air to get out another word.
‘. . . call . . .’
Not an ambulance, this time. Another car service took us the eight blocks to my home from home at Methodist Hospital. Neal met us there. Beth didn’t need to manage this situation entirely alone.
This was the emergency room where I had been admitted on the night of The Event. As on that night, some of the less urgent cases were sitting in a waiting area, greyly waiting to be called. Doctors and nurses and paramedics quietly moved among gurneys.
While we were being admitted, Beth said the magic words, ‘He’s short of breath. He thinks he’s having an asthma attack.’
Sparky had told us before that the secret to getting quick service in an ER, if you couldn’t fake a good – or preferably, really awful – cerebral haemorrhage, was to claim an asthma attack.
But I was, in fact, having an asthma attack. I was allocated one of the gurneys, and a resident doctor quickly arrived and introduced herself.
‘Hello. I’m Doctor Athena Mihailos. What seems to be the problem?’
Everyone was introduced, the symptoms were described and confirmed, and Athena strode off to source a round of drugs and a nebuliser so I could breathe them into my lungs as a mist. After it had all arrived and I was breathing more easily, the sense of throbbing red panic diminished and Neal and Beth and I began to have a grand old time. We waited for delivery of a further prescription for various types of steroids and began to speculate about whether we would be home in time for Doctor Who, of course.
I removed the mouthpiece to join in for a second. ‘Athena. What a great name.’
‘Yeah, who is that?’ Neal wondered. ‘The goddess of knowledge?’
‘I think she’s the goddess of war,’ Beth offered.
Speaking of the goddess, the doctor arrived with the steroids. Neal decided to put the question to rest. ‘Can you tell us,’ he asked Doctor Mihailos, ‘is Athena the goddess of war, or the goddess of wisdom?’
‘Both,’ she growled, and we all laughed and got to chatting.
Athena hadn’t immediately recognised the young woman accompanying the guy suffering the asthma attack, but after a quick reminder of my now-legendary bleed, it all came flooding back to the young doctor with the long, dark hair who had seemed so serious at the beginning of October. She and Beth began discussing the subject of telling family members that a loved one was on the way out.
‘I remember you were really upset.’
‘I felt like you guys were trying to tell me that he was probably dead.’
‘Well, yeah . . . But there’s always a chance that they might not die, so . . .’
So, the effort to keep me alive continued. When I’d last had my meds tweaked, I had been taken off Lisinopril, my original blood pressure-reducing ACE inhibitor, because it was causing a regular, dry cough. I had been put on Labetalol, a beta blocker, instead.
I was always wary of beta blockers. They reminded me of Big Bill Werbeniuk, and how they’d finished his snooker-playing career. The 250lb Canadian drank around six pints of lager before a match and then another pint for each frame he played. Apparently, he did this to counteract a tremor in his arm. Whatever it did for his tremor, all this booze put a terrible strain on his heart, so he started taking Inderal. This beta blocker was considered to be a performance-enhancing drug by the World Professional Billiards and Snooker Association, so he was fined and suspended. Big Bill went home to Vancouver to live with his mother, on disability benefits. He played cards, watched telly, went bankrupt and died of heart failure.
On this day, the outco
me wasn’t nearly as bad for me, but we found out that Labetalol did have the risk of causing bronchial spasms, and was not advised for asthma patients. Which was a shame, because it was keeping my blood pressure under excellent control. Instead, Athena sent us home with a new rescue inhaler, a steroid inhaler, and orders to visit the doctor treating my hypertension. We settled into the big orange couch again, and Beth and I began our latest effort to lead a somewhat normal life.
16
Sisyphus
Life seemed to have become an endless procession of trips to the emergency room, punctuated by more regular check-ups. The week before Christmas, I had written an impassioned message to a friend regarding the reluctance of a family friend of hers to address his high blood pressure. The gist of it was, that was fine for the family member, but they needed to think about the devastation they’d be wreaking on their loved ones when the pigeons came home to roost.
Shortly after I had finished with my correspondence, I got a call to schedule my latest late-breaking home nurse check-in. Not for any particular therapy this time, but for the nurse to check my vitals. This included taking a blood pressure reading, which was a bit high on the first reading on my right arm. Then on my left arm. On my right arm again. By the time we took a follow-up reading with an electronic monitor, we’d been on the phone to Doctor Im, and I was very stressed out. Another high reading. The recommendation from the nurse and Doctor Im was that I get myself to the emergency room or an urgent care centre so that a doctor could see me in person, and fiddle with my meds as necessary.
My feeling was, my readings had been good for the past month, so why were we getting me stressed on account of one set of bad readings? My frustration with this aspect of the evening was getting me even more het up. However, the professionals were concerned enough to make a big deal about it, and in light of my recent email, it would have been ridiculous not to get things checked out.
Stroke Page 16
