by Dave Liniger
“Dave, you’re having a nightmare. Do you know where you are?” they’d ask.
Sometimes I could answer; other times I could not.
“Dave, you’re in the hospital. You’ve been injured and you’re having nightmares. I’m your nurse and I’m sitting with you to keep you safe. You’ll wake up and it will be daytime again soon. I’m here to take care of you. Don’t be afraid.” They always spoke in a calm, rational and kind tone.
I was terrified by these experiences. I had no control. I couldn’t sit up, swing my legs over the side of the bed or stand. I couldn’t turn on the lights, find the switch to call the nurse or anything else that seemed so near and yet so very far. Sometimes I’d go to sleep with the nurses call button tied to my bed rail, but even then I didn’t always have the strength to get a hold of the rail, pull myself over and grab the switch. To compensate, I’d put the switch in my hand or lay it on my chest.
I’d doze off, and even if I wasn’t hallucinating, I could still hear that strange gurgle in the back of my mind. Months after the hallucinations started, I began to regain my cognitive reasoning and realized the gurgling sound was actually coming from the IV pump they had me hooked up to. It would pump for eight to ten seconds and then reset itself. When that happened, it made a gurgling noise. I didn’t recognize it when I was awake until one day it just hit me: That’s the noise I heard in the background of every hallucination I had.
As I began to get better, the doctors took me off the pain medication that likely induced the hallucinations. They subsided, but the terror never truly went away. Once I started thinking clearly, I worried about how I would get around on my own, specifically how I would get to the toilet by myself. I worried about regaining my speech and my overall quality of life. I wasn’t even sure I’d ever regain the motor skills needed to wipe or feed myself. I still couldn’t hold a tissue between my fingers. I obsessed about being a burden on my family and friends, something I found terribly disturbing to even think about. I had always been the caregiver, not the care-“taker.” This new role was not one I could readily accept, which would make things harder for me than they needed to be. Still, I’m the kind of man who would rather find my own way than depend on others for the basic necessities I’d come to take for granted. It was humiliating and frustrating to think that this is who I would become if I allowed it.
JUNIOR
For me to calm my head, I like to hear background noise, so I often turn on the TV. When I stayed with Dad, I kept the television on and listened to the news all night through the earpiece they give patients. I sat right next to his bed. Even though he was out of it most of the time, I’m positive he was aware of what I was hearing, especially when his delusions started. They all seemed tied into some story I was listening to on CNN, especially Operation Fast and Furious, which was going down at the same time Dad was in the hospital. Of course, they also seemed to correlate to being trapped in his bed for so long. I’m sure Dad didn’t like the way that made him feel.
MARGARET KELLY
I was visiting Dave one afternoon when he asked me to hand him a tissue. I handed it to him without thinking he might not be able to hold it. The tissue slipped through his thumb and forefinger and fell to the floor. I quickly handed him another. Again, he wasn’t able to close his hands with enough force to hold it. This realization brought tears to Dave’s eyes. I took a third tissue from the box next to his bed and began wiping my eyes, saying, “It sure is dry in here. Isn’t it?” Without missing a beat, I dabbed away the tears from his eyes and said, “We ought to get a humidifier in here. It’s too dry.”
These are the thoughts that come into your mind when the sun goes down and everyone has gone home. When morning came, the nurses could always tell I’d been awake all night. They could see the worry and shame in my eyes. Still, I’m a man’s man who would never admit I was scared, especially to a woman. Now, that’s not a sexist statement so much as it’s one filled with the bravado I was talking about a few pages back. You see, the bravado returns when the sun comes up.
“Are you ok, Dave?” the nurses asked.
No matter what I said, they knew I wasn’t, and they never once emasculated me by pointing out the obvious. They’d simply pull up a chair, hold my hand, rub my arms or legs and talk to me until my mind and thoughts were diverted to something positive. They knew I wouldn’t talk about how I was really feeling so they did their best to help me move through it with kindness and compassion.
Once I was on the road to recovery my cognitive thinking returned. To monitor my cognitive reasoning skills, a therapist came to my room every day to ask me a series of simple questions. The first was always, “What day is it?”
I finally had my kids put the day and date on the wall behind the therapists so they couldn’t see it.
“Today is Wednesday, May 16th, 2012,” I’d promptly answer.
“Very good! You’re coming right along!” They never once figured out what I was doing.
Around the same time, one of my nurses started talking to me about dealing with my Post Traumatic Stress Disorder—PTSD. I had no idea what she was referring to. But then I realized my psychiatrist was trying to tie my hallucinations to my time in Vietnam.
As part of my healing process, I sat with a psychiatrist twice a week. He said it was obvious to everyone there that my dreams, nightmares and hallucinations were all indications that I was suffering from my time serving in the war. I adamantly disagreed, as the hallucinations first started during my hospital stay and immediately ended when I was taken off a certain pain medication. In my everyday life prior to getting sick, I hardly ever thought about the war, and I certainly never suffered disturbed sleep from serving in the military.
Vietnam veterans get a real bum rap because society wants to paint them as damaged goods, when in fact our rate of suicide, drug abuse, alcoholism and homelessness is no different than those who served in World War II. The media created the story about soldiers who came home from Vietnam who couldn’t fit into society. Sure, there were those who genuinely suffered from their experiences, but there are also some who took advantage of it and used it as a crutch. That’s not unusual and it certainly isn’t the first time in history it happened. I was vehement with the psychiatrist that my issue wasn’t PTSD but rather the fact that I was paralyzed and handcuffed to a gurney. I was unable to move and was scared to death because I was on such heavy drugs for my pain that it was messing with my brain. If that suddenly clustered me into a lost generation, it was time to review my entire life.
Once they took me off of that drug, the hallucinations stopped and my world began to slowly come back into focus. I’d still wake up in the middle of the night, but at least I knew where I was and the reason I was there, and though there were still moments filled with fear, given my circumstances, they were reasonable and to be expected.
I was clearly getting more and more like my old self—and I liked the way that felt.
CHAPTER 9
Just 10 Feet
“What lies behind us and what lies before us are tiny matters compared to what lies within us.”
-Ralph Waldo Emerson
The last prescription my doctors gave me for pain was one hundred and fifty tablets of morphine. He told me it was better for me to live through my pain—to learn to use it as motivation to move, build muscular strength and to stand up again. After four months of being flat on my back in hospital beds, most of my muscles had atrophied. I had no quads, glutes, abs or framework of muscles to support my spine. If I had a prayer of getting back on my feet someday, I would have to start by building enough strength to support each of those muscle groups just so I could sit up on my own.
When my physical therapy began, the techs had to use a lift to get me out of my bed and into a wheelchair. The lift had a yellow tarp, which they would slip underneath me. I had to roll onto it so they could wrap the remainder of it around my body. There were straps that came up between and outside of my legs with another two t
hat went over my shoulders. The lift itself dropped down from the ceiling above my bed or exercise platform where I would have my physical therapy and daily exercise sessions. They would snap the lift to each connection point on the tarp and slowly raise me into the air until they could position me into my wheelchair. This same device was used every time I needed to be placed on or taken off a therapy table and in or out of my shower chair.
At the time, the use of the lift was excruciatingly painful for me, especially on my lower back. I told my doctor that the lift hurt my back and made it feel worse than before my surgery. He reluctantly told me it would be that way for six to eight months. I had no choice but to get used to it.
As a way to help alleviate some of my discomfort, the doctors ordered a custom brace that wrapped around my back and chest to see if that would make moving any easier for me. It helped, but it certainly didn’t make it less painful. I used the brace with a chest plate for about two weeks while I worked on strengthening my core muscles. As I slowly grew sturdier, I graduated to using the lift without the brace, which was still painful but no longer unbearable.
I made my stay at Craig a personal competition against myself. I pushed my body harder than any of the therapists would have, especially in the beginning. They were experts in dealing with patients who needed to be inspired, driven and pushed hard. They had no idea how to handle my level of commitment when I came along. I remember the first time they placed me in my standing chair, a wheelchair that has a plate that drops down and locks you in place so you don’t fall out when they crank the chair into an upright position. Your knees and legs are like vices in those chairs. The seat slides up so you can stand straight. Your total body weight is on your legs but you can’t fall because you’re locked in from the body plate. I knew it would be painful to use, but I wasn’t afraid. If I could conquer this exercise, I’d be allowed to move on to using the robot machines—the ones that physically move your legs to help teach your muscles by example how to move the proper way again.
“How long do I have to stand in this chair before I can use the robot machine?” I asked.
“Twenty minutes.”
“How long does everyone usually stand on their first try?”
“About a minute or so.”
“I’ll make the twenty minutes the first time,” I said, full of audacity and conviction.
“Dave, nobody has ever done that. It’s impossible.”
“I’ll make it. I’m all about making the impossible possible,” I said. And I meant it, too.
Before we started the exercise, I thought back to my training as a jet pilot. While flying jet planes, you use a pressure suit that expands when you start to build G-forces during aerobatic maneuvers. The suit pushes blood out of your legs and chest, back into your brain so you don’t pass out. The pressure suits work to about 9 G’s, but some aerobatics I learned took me to 13-15 G’s. In flight school, I was taught to hold my glutes, abs and quads as tight as can be, as if you’re sitting on a toilet while constipated, and to push as hard as you can. That extra pressure pushes blood into your head so you stay conscious. Once you know how to do that you can call upon it in times of need.
I had been flat on my back for several months. I was barely sitting up in bed on my own and my blood pressure hadn’t yet regulated to become stable. Doing this exercise over time was a way to improve that. An ordinary standing person shouldn’t have an issue with blood flow. However, if you’ve been lying on your back for any extended period of time, the changes to your body are immense. The blood starts draining out of your head much quicker, which means you are prone to fainting. This is one of the reasons I had to be monitored all of the time. The hospitals are scared to death of a patient fainting, falling and getting hurt. The techs were watching me very closely, especially as the one minute marker turned to two, then five then ten. So when they placed me in the standing chair, I didn’t fully understand the danger I was flirting with as they cranked me into the full upright position.
“Are you ok, Dave?” the tech asked.
“Get me all of the way up here. Let’s go!” I said as I began doing my own exercise to push more blood into my brain.
“Dave, whatever you do, please don’t faint. Tell us if you’re going down!”
I thought I was going to make the full twenty minutes, but at fifteen minutes and twenty seconds, I had to give up.
“Ok, put me down. I’m about to faint and throw up.” I conceded.
My failure and my queasy stomach bothered me for well over an hour, but then I got over it and asked if I could give it another try tomorrow.
“Not until we talk to your doctor!” they said.
The techs were initially scared by my will and determination. A typical patient would take four or five weeks to work their way up to fifteen minutes in the standing chair. They agreed to let me try again but on the condition that they monitor my blood pressure every three minutes. I nailed the twenty-minute threshold the very next day. Surprisingly, my blood pressure didn’t vary a single point the entire time—probably because I was squeezing and pushing blood into my brain, but they didn’t know it.
Body part by body part, I was trying to get back to where I could stand and then walk on my own. After four months, my catheter had become rather uncomfortable. With all of the hard work I was doing, it was also getting in the way. The biggest concern about having a catheter in a man for so long is that the bladder gets weaker and might never come back to full function—meaning, I might not ever be able to urinate on my own again or worse, have any control over this bodily function. Sympathetic to my discomfort, the doctors agreed to remove the catheter to see where I was at. Believe me, removing the catheter is just as uncomfortable and painful as inserting it. The good news is, I peed like a champ. I was able to void as much urine as I was holding in my bladder every time I went. The bad news was that I didn’t have a lot of control over my need to go and my ability to hold it, so in the beginning, I occasionally wet myself. I was terribly humiliated and embarrassed the first time this happened because I missed my first Lokomat session as a result. A Lokomat is an automated treadmill where the patient’s legs are guided according to a pre-programmed physiological gait pattern. It helps make the leg muscles stronger and promotes more muscle mass. I hated that I kept all of the Lokomat therapists waiting while a nurse had to clean me up. I swore I would never do that again—wet myself or keep the good-hearted people who were there to help me heal waiting. I was respectful of their time, just as I wanted them to be of mine.
I spent the next several weeks working on my balance, strength, muscle-building and movement exercises. The therapists were extremely kind and cooperative with my demanding physical expectations. My overall physical therapy routine was designed to get me to that next step where I could attempt to start walking on my own. They tried to be extra cautious with me, but I wouldn’t allow it. I wanted to push harder, make quicker progress and give one hundred and fifty percent of myself each and every day. It got to the point where they finally gave in and said, “Go ahead and do what you want because we know you’re going to anyway.” And they were right. I pushed them to push me—which has been a common theme througout my life. Everything I have ever done has been about pushing others as a way to push myself harder and to reach for a higher standard.
I wasn’t willing to stay disabled. I wasn’t ready to accept that I might not walk again. I wasn’t choosing that life. I was choosing to do whatever I could to avoid it. I reminded everyone that I was one tough guy who could take whatever they asked me to do as long as it brought me closer to my goal. I wanted to walk again—the sooner the better.
I was still obsessing over what it would mean to walk just ten feet. Ten feet meant I could have a perfect life. I could get out of bed and take two steps to sit in my chair. I could get out of my chair and take two steps to sit on the toilet. I could take my chair to the car and not need a handicapped van. If I could walk ten feet, it would be the impetus to wa
lking twenty. If I could walk twenty, then I could walk a mile. To me, ten feet meant freedom and independence.
Some patients at Craig were just like me—gung ho and willing to try anything to make their life better by improving their health. Others didn’t have that drive. Many of the patients there were young, immature and had never been given the chance to succeed at anything in their lives. They tell their therapists they don’t feel like doing an exercise because it hurts too much. They refuse to cooperate and as a result, stay exactly the same each day. Though the physical therapists and techs do their best to encourage them to participate in the program, each of us is there of our own free will. They can’t make us do anything we don’t want to do.
JUNIOR
Dad has always been black and white about everything he does. He’s all in or he is out, so you never have to question where he stands on things. When it came to his rehabilitation, he wasn’t going to give an inch in his fierce determination. He would keep working as hard as he could until he hit the point of exhaustion or someone else stopped him from hurting himself. I’d attend his therapy sessions and would watch other patients come in asking if they could cancel because they really wanted to go back to bed and watch TV. Not Dad. He’d do his session and ask for an additional half hour. He would struggle through every grueling minute and refuse to quit. I don’t think I’ve ever witnessed my dad quit at anything he set out to do—and I knew for sure, he wasn’t about to start now. He always said, “Small failures, amazing achievements.” He was willing to do everything necessary when a lot of other people would have given up. He had an unstoppable, bear-down-and-get-it-done attitude that was a constant affirmation of how strong he really is.
