Let Me Drive!

Of the eight men in my physical therapy group, I  guesstimated that all but two were more disabled than me. Three of the group members were using walkers, and one actually was in a wheel chair. One group member relied only on a cane, as did I, but his gait was very slow and crablike. I ranked  him below myself on the mobility scale. The two group members who appeared less disabled than me were twenty-somethings, seemingly in good shape, and apparently in no need of assistive technology.

I closely scrutinized my fellow group members because they were the first stroke survivors I had encountered. This was not to  say I hadn’t unwittingly crossed paths with numerous stroke survivors, but prior to my stroke I had been oblivious to the ravages inflicted upon stroke victims. Now that I’d suffered my own stroke, I realized  that I was  almost obsessed with learning every detail of the circumstances surrounding the strokes of each of these men.

Jan was 15 when he emigrated four years ago to the U.S. from the Czech Republic with his parents and two sisters after his father took a position as a civil engineer. Jan reported that he was heading from his dorm room to class  at Northwestern University when he realized he could not raise his arm to open the door. “Stroke runs in my family so I was not foolish about what is happening to me,” he said. “I called 911.”

Within 15 minutes, Jan arrived at Evanston Hospital via ambulance where the ER’s stroke unit determined he was a candidate for  tissue plasminogen activator, or “TPA,” the “strokebuster drug,”  given that  Jan’s symptoms had manifested themselves well within the 4.5-hour timeframe when TPA is most effective. TPA, which quickly breaks up any clots it encounters, worked like a charm. Jan would be released from the hospital the following day after his medical team determined that he had he had weathered his stroke with virtually no permanent deficits. (It occurred to me that if I, of all people, had even a modicum of common sense, I would have had myself rushed to the hospital from Charleston Airport when I was so obviously  “stroking out.”

Jeff, the man with the cane, seemed to have great difficulty finding the words for what he wanted to say. (I would later learn that this condition, “aphasia,” is an impairment caused by damage to the brain affecting the production or comprehension of speech.

From what I could gather from his halting narrative ,Jeff had awakened one morning with a stabbing head ache. He had tried to shower and get dressed but the pain was such that he instead dialed 911. His was a right side stroke. I had learned from Stroke for Dummies, neurologist Dr. John R. Larler’s contribution to Wiley Publishing’s “Dummies” empire, that problems with language almost always point to damage or injury on the left surface of the left brain.

Consolation to Jeff, I thought to myself, is that apparently those who survive a right-side stroke often experience a fuller recovery than do those who survive a left-side stroke.

Greg’s stroke was similar to mine, a “left-sider,”  only it was precipitated by a clogged artery, as opposed  to a tear in the artery. I recall him saying he was 52. (Let this be a lesson to all of you, dear readers, who disregard your doctor’s concern over your cholesterol levels.) Greg said in hindsight that the three episodes during which his body “locked up”  for intervals ranging from a several seconds to nearly half a minute were worth heeding. These alarming symptoms occurred over a span of a week, and then  abruptly   stopped.  TIAs,  I thought.  According to Stroke for Dummies, these are transient ischemic attacks, or “mini-strokes,”  which are too fleeting to cause any lasting damage, but which are almost always precursors to a more serious stroke.  Sure enough, Greg’s final episode was the real deal. His wife drove him to the emergency room despite his insistence that what he was experiencing could not possibly be a stroke. (Sound familiar?)

(These are the  cases I can still recall in some detail. As for the others in my group, I do recall that one of the guys, whom I had  assumed was in worse shape than me, was discharged by week’s end after his medical team determined he would fully  recover and henceforth would do his physical and occupational therapy on an outpatient basis.)

After hearing the testimony of each group member, our facilitator told us that we would meet as a group on alternating days. He then assigned each of  us our own physical therapist to work with us during non-group days.

My New Roommate

Two events occurred shortly after I returned to my room: an orderly came in to measure me for a leg brace, and I gained a roommate. Two nurses wheeled in a bed containing an elderly man who managed to look regal even in his hospital gown. I took me a minute to figure out who he reminded me of. Yes! Hugh Downs! A slightly older, slightly gaunter version, and minus the laugh lines  behind the eyes.

Entering the room directly behind the nurses was the very epitome of the straight-outta-Winnetka –Town & Country emulating-tree-hugging North Shore dowager. She was wearing cropped khaki pants, tan deck shoes  and a white button-down  blouse. A red sweater was wrapped around her waist — cashmere, I’m sure. She looked  considerably younger than the man I assumed was her spouse, but this may have been testimony to the money she had invested in beating  back the ravages of aging.  The orderly taking measurements for my  brace paid no heed to the  commotion.

“It will be here in about a week,”  the orderly told me. At that moment, one of my nurses entered the room, exclaiming, “Have you met your new roommate, Mr. Cosgrove? “

“No I haven’t” I replied diplomatically.

 Well let me introduce you to…” she glanced quickly at her chart, “Mr. Ronald Hamilton, and his lovely wife…”  she stole another glance at the chart. “I’m sorry, you would be?”

” Jennifer Hamilton,” his wife said pleasantly. At this point, Mr. Hamilton directed his gaze to me and said, “Nice to meet you Mr. Cosgrove.”

“Call me Tom,” I insisted.

After a moment’s hesitation  (and I think maybe a nudge  from the wife) , he replied, “Call me Ron.”

 With that, Ron redirected his attention to his wife, who periodically glanced my way. My sense was that she was an inherently sociable person who felt a little awkward that her husband was not making any effort to talk to me.

I ordered lunch, a pepperoni-and-sausage personal pizza, a cup of mixed fruit and a Mountain Dew. My food arrived, and when I placed the book I was reading on my bedside table, Mrs. Hamilton found her opening. “I’m sorry,”she said,  “but I couldn’t help but notice that the book you are reading has the Navy Seal insignia on it”

She had a sharp eye. “It’s called No Easy Day: The Firsthand Account of the Mission that Killed Osama bin Laden, ” by Mark Owen, a former Navy Seal,” I said.

“Did you have that, honey,” Jennifer gushed.

“Do I have that book?” Ron whispered loudly to his wife. “I wish I had it.”

“It just came out,” I Volunteered.  “Would you like to see it?”

“I certainly would appreciate seeing it at some point,  but not right now. I don’t want to interrupt your reading.”

  Not a problem, I insisted.

 “Oh, but you are still eating!” said Jennifer.

“Well anytime you’d like to see it, just say the word,” I offered.

I finished lunch. Ron appeared to be taking a snooze, while his wife pulled his personal items from an Orvis tote bag and neatly arranged them in his bedside cabinet.

I started dozing off myself to the low-volume drone of the Caylee Anthomy trial on CNN,  when Ron called out:

“Have you served in the military, young man?”

 I mentioned that I did a stint in Germany as a drug and education  specialist.

 Ron asked me a few questions about my experiences in the Army, until Jennifer interjected and said with a clear note of pride in her voice , “Did you know that my husband was one of the original Navy Seals?”

After feigning  embarrassment, Ron told me he was a member of the  Underwater Demolition Team, or “UDF.”  Created during World War,  these were specially trained U.S. frogmen charged with  identifying and reconnoitering landing beaches , maintaining positions  on the designated beaches prior to landings, guiding  in assault craft, and assisting in the rescue of wounded soldiers.

Ron  told me that  most of the missions in which he participated were possibly still classified, but he did acknowledge that he was part of Operation CHROMITE, the amphibious landing at Inchon that marked or nation’s first large-scale entry into the war. He said his team  infiltrated the beach ahead of the landing craft, scouted the  mud flats, marking low points in the channel, and dismantled concealed mines.

” I lost two of my best buddies that night,” Ron reminisced , but the landing was a success. We caught the North Koreans  totally off  guard.”

“President Kennedy formally renamed the team Navy SEALS in 1961,” Jennifer beamed. “SEAL stands for Sea, Air, Land.”

 “Show off,”Ron snorted.

  Coverage of the  Casey trial had concluded for the day, so after dining on another personal pizza and a side of triple-fudge brownie, I selected from the list of thirty-or-so movies on the hospital’s version of “On Demand.”

(Upon  discharge, I will have cycled through the entire hospital film library and will have re-watched another six or so. Likewise, I will have read four books in addition to No Easy Day. You would need to spend at  least a couple of weeks in a hospital to appreciate the true glory of  enforced idleness.)

My  selection for the evening was The Losers, an over-the top, and I suspect, tongue-in-cheek, action-adventure flick featuring seven rogue mercenaries that I would rate as one of top three in that genre.

The next morning, after showering and enjoying a breakfast  of  French toast and a pineapple milkshake, I awaited my first occupational therapy session. Dr. L, head of physical medicine, stopped by my Room for what I thought was a standard briefing.  instead, after going  over the basic details, he dropped a startling piece of news  on me.

“The protocol for anyone who has suffered a stroke or is suspected of having any kind of cognitive impairment,” he announced, “is to have them pass a driving test before we can clear them to operate a motor vehicle.

“But I have been driving!” I sputtered in disbelief. “Since my stroke, I’ve driven to and from work twice, I drove all the way to Southwestern Wisconsin and back, and I drove myself to the hospital!”

  I fully appreciate that my stroke had caused me damage, I thought self-justifiably, but I clearly was fully in  possession of my cognitive faculties!

“Be patient, Thomas,” Dr. L tried to reassure me.  “You can  decide you’re ready to test any time you think you are ready.  My suggestion would be to go through a round of occupational therapy, which will include activities designed to reestablish your driving skills, if necessary, and when you are ready to take the road test you can let us know.”

 Dr. L also took the opportunity to mention that many stroke victims are in denial of their deficits, which, in and of itself, is an indicator of stroke damage.

 With a hearty  slap on my back,  Dr. L  introduced me to Jenny, my occupational therapist.

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