Mention Florida, even to this day, and I see a brace of coonhounds braying for the sheer joy of it, splashing through backwater ponds choked with water hyacinth. I see small hamlets appearing like mirages through thickets of palmetto and stands of loblolly pine along crushed-shell roads littered with rotting heaps of vegetation, the occasional dead armadillo, and God knows what else. I see men like Hank Kenshaw jockeying airboats across sawgrass prairies that stretch to the horizon.
My parents would chuckle when I insisted, even as an adult, that I could still remember the sound of that airboat from my first Florida visit. I had just turned four, yet I still hold the vivid image of that motor, which Uncle Hank had salvaged from a Cessna prop plane, roaring to life, and the sight of the still water of the lagoon just behind my uncle’s house suddenly erupting into furious sheets of waves as cattails lashed about like live wires.
I was on the dock with my dad, which he later acknowledged was about the most dilapidated structure he had ever dared stand upon. He was holding me on his shoulders while warily eying the tea-brown water below, which Uncle Hank delighted in warning us was lousy with gators and moccasins. Mom, who was holding my baby sister, reflexively backed all the way up the dock and onto the wrap-around veranda of the Kenshaw’s house before inching her way back toward us in a valiant effort to get within rescuing distance, if necessary, of her husband and first-born.
When Uncle Hank fired that thing up it was like standing 10 feet away from a jetliner. He stepped into the water and slowly turned the boat so that it was facing out toward the lagoon, ostentiously to avoid blowing us off the pier. But all that accomplished was to further whip up the water to the point that we expected the whole thing to collapse. Uncle Hank thought it was hilarious.
I also remember the plum-sized lump on Uncle Hank’s left wrist, the consequence of an airboat mishap that left his hand dangling by a few tendons. He managed to hitch a ride to. Melbourne, the closest town with a hospital. Family lore has it that the surgical team on call at the ER that night tried to convince Uncle Hank that his nearly severed hand was beyond repair . However he insisted that they do everything in power to reattach it. The surgical team did manage to reattach his hand and Uncle Hank was able to retain some rudimentary ability with it.
The accident did not deter him from heading back into the swamp to gig frogs, poach the occasional plume bird or alligator, or do whatever else was necessary to provide food for his family, all by the light of a miner’s headlamp.
As luck would have it, Uncle Hank was one of the first Floridians to reap the rewards of the new technological era. He had some land, thirty-odd acres of “wet pasture,” with a view of the ocean (if a wildfire cleared the vegetation and you had a pair of good binoculars.) By sheer happenstance, his spread lay not far from the Joint Long-Range Proving Grounds, where rockets periodically ripped through the night air, stilling for a few moments the relentless chatter of the bugs and frogs.
A few years after Russia launched the first artificial satellite in 1957, Uncle Hank sold his land to the National Aeronautical Space Administration. Again, family lore has it that when asked about his new status as a wealthy man he would say, “Sputnik sailed over our house one night and dropped a nice chunk of change in my lap.”
Later, he and a partner would start a concrete company and earn an additional small fortune paving some of the runways and tarmacs under contract to NASA
Our Second Florida Trip
Three years later, we made our second Florida visit. Uncle Hank was still in negotiations for the sale of his land, but some money must have rolled in, because he and my aunt Rosie had already purchased an 8-millimeter movie camera along with a movie projector. I recall spending a good part of the day clowning around with my cousins, and then watching movies of our antics that evening.
At some point during our visit, Uncle Hank took his oldest son Danny and myself on a drive in his pickup truck. After stopping at a small marina where he brought a stringer of red snapper from a fisherman who had just docked, Uncle Hank drove out toward the bay, stopping at a spot that gave us a wide vista. I was getting my first glimpse of the ocean, and I mentioned to Uncle Hank that I had expected to see big waves and surf crashing against the rocks. I don’t exactly remember his response. What I do remember is him saying later in a low voice, “Feel how still and quiet it’s getting.”
It was true. All at once, the whole world seemed to be holding its breath. The water was smooth as a mirror. The terms and the seagulls that had been circling over the bay had fallen silent. The clouds seemed frozen in place.
Then Uncle Hank started talking again in the same quiet voice. “There’s plenty of noise in the world, but I for one like to keep my eye on the quiet things, like that big cloud out there.” He gazed out over the bay. “Why don’t you watch it with me for a couple of minutes?”
That’s the indelible image I have — Uncle Hank facing the bay, contemplative, occasionally muzzling the rough of the coonhound he had brought along for the ride, while that cloud slowly started filled the sky, taking on the shape of a massive black anvil.
On the way back, Danny and I sat in the bed of the truck at Uncle Hank’s insistence, as an uninterrupted sheet of rain pelted us. By the time we got back to the house and pulled into the gravel parking bay, which was under several inches of water, the clouds had disappeared and the sun was out in full force. Vapor steamed off the pond-sized puddles and kudzu-covered telephone poles along the road. As we climbed shakily off the truck, mom ran inside to fetch towels. Meanwhile, Aunt Rosie upbraided Uncle Hank for letting us get so drenched.
“Young Tommy’s got something he can brag on when he sees his buddies up North,” was Uncle Hank’s reply. “He survived a good old-fashioned Florida monsoon.”
That evening, as Uncle Hank grilled snapper, I regaled him with questions about Florida. I was particularly interested in the venomous snakes, alligators, jellyfish. sharks and other creatures too exotic to live in a place as ordinary as Chicago. He told me about his younger days wrestling alligators with a traveling carny show. He said that the alligators were so lazy and well-fed that they sometimes dozed off while waiting to go on stage. He explained that a gator’s jaw muscles are arranged in such a way as to enable it to clamp its mouth shut with ferocious power. However, he added, the muscles to open the jaw were weak, and a skilled wrestler could hold a gator’s jaws shut with one hand. The wrestler would then embrace the gator with his other arm to give the impression that he was trying to subdue it by brute force.
“What he was really doing was hypnotizing it by scratching its belly,” Uncle Hank explained. Then he added, “Usually, if I’m talking to a Yankee tourist, I’ll hold up my crippled hand and say that some monster of a gator bit it off and ate it, but I wouldn’t try to pass that off on a smart young fellow like you.”
Uncle Hank comes to Chicago
I had just turned 13 when, six years later, Uncle Hank bought his family up to Chicago. Flush with cash, Uncle Hank was driving a pink Cadillac Eldorado. He announced his arrival by hitting his horn, which was modified to sound the first four notes of “When the Saints Go Marching In.” I ran out the door to greet Uncle Hank and kin about the same time as several inquisitive neighbors stepped onto their front porches. What we all witnessed was the spectacle of four giggling girls piling out of the car, as Uncle Hank laid on the horn one more time for good measure.
“I gotta pee like a racehorse!” one of the girls exclaimed, as Aunt Rosie and Danny emerged from the car. Dad wasn’t home from work yet, so it was up too my mom to assume the role of official greeter.
“So good to see you, Rosie!” she gushed, hugging her sister, before turning and calling out to the girls. “Sweethearts, the door is open!”
Uncle Hank strode around the car to join Aunt Rosie and mom. I lingered outside the house long enough to hear him exclaim, “My God, Doreen! How do you keep yourself looking so beautiful!”
During their stay, I spent a lot of time with Danny, who was just a couple of months younger than I was. I was fascinated by him. For instance, He might start a conversation boasting about the size of the bass he caught in a local canal, then shift to his plans to join the CIA, Danny’s brother, Hank, Jr., spent much of the visit lurking behind doors or furniture, springing from where he was hiding in the hopes of catching one of us by surprise.
And then there were my girl cousins. The highlight of the visit occurred the night Uncle Hank drove with Aunt Rosie to Waukegan to visit one of his buddies, leaving the kids behind. That’s when the Kenshaw girls decided to shower together in the upstairs bathroom. After at least a half an hour of giggling and splashing, the girls emerged shrieking and laughing from the bathroom soaking wet wrapped in a single beach towel. Attracted by the commotion, everyone in the house converged near the top of the stairs. I realized with anticipation bordering on delirium that the girls appeared to be on the verge of losing control of the towel as they scuttled toward my sister’s bedroom. Sure enough, midway down the hall one of the cousins apparently lost her footing, bringing down the whole crew, at which point, Hank, Jr., popped up out of nowhere to snatch away the towel and fling it over the stairway banister.
It was at that moment that Dad, who was the last to climb the stairs, suddenly froze. I can still recall the look on his face as he will stared, mouth gaping. Catching my eye, he recovered his composure and said, “Girls!” in a tone that was both a sigh and an admonition. “Those are your Florida cousins for you,” he muttered, managing to crack a smile.
Only years later that I determine that his smile was one of complicity, and acknowledgement that he and I had just witnessed something rare and exotic, something imported from a hothouse climate far removed from our northern urban prairie — a little gift from Uncle Hank and Aunt Rosie, along with the shellacked puffer and the big, white conch shell that held within it the sound of the ocean.
in addition to playing piano, tying flies, and wading trout streams, my stroke robbed me of the ability to do watercolors. The painting above was done in 2003. The painting below was done in 1999. The third picture painting was done when I was a junior in high school.
When last we left off, I had just failed a driving test administered by an instructor under contract to the hospital. My suspicion was that he was incentivized to fail patients the first go around so he could encourage them to go through another round of physical therapy. (money in his pockets, money in the hospital’s pockets). By the same token, however, I could appreciate that many stroke victims or others with cognitive disabilities believe they are perfectly capable of driving.
With this in mind, who was I to think that I wasn’t in the same boat? As I explained to Dr. I, the actual patient remains the one most suited to evaluating his or her condition. Of course, impaired patients can have a warped sense of competency, but isn’t trust a critical component in the doctor-patient relationship? “Trust me,” I urged Dr. I. “Even though my instructor, for whatever reasons, tried to knock me off my game, I still should have passed.”
Needless to say, I did not mention my unwillingness to cough up another $460 out of pocket to repeat the test.
Barely concealing his exasperation, Dr. I made a proposal: “You can take a driving test from a repeatable private instructor, and if you pass the test I will reconsider.”
I cannot recall the name of the instructor with A Adams School of Driving who picked me up three days later for a driving test at a cost of $90, but all the stress and anxiety roiling around this “make-good” test vanished when a jovial, somewhat rumpled man, who looked at least 60, pulled up at the hospital entrance (where I was waiting) and greeted me with, “Are you ready to tear up some road, young fellow?”
I scored 99 out of 100 points ( I apparently forgot to adjust my side view mirror upon entering the car). What a relief! My name would not be on the list of patients that Dr. I periodically forwarded to the Secretary of State, along with his recommendation that their driving licenses be temporarily “pulled” pending further medical review. Thus, I was spared the need to drive without a valid license, always looking over my shoulder for approaching cops, never exceeding the speed limit, because, truth to tell, there was no way I would had completely given up driving.
A Visit from Dr. M
I should note that although I was nearly 10 days into my hospitalization and had managed to reinstate myself as a qualified driver, I had only seen Dr. M once. As you may recall, Dr. M was the neurologist assigned to my case after I had my first stroke. I quickly became enamored of the man, and initially was much reassured by his conviction that my likelihood of getting a second stroke was no greater then the likelihood of any male my age getting a stroke.
On the second day of my hospitalization, Dr. M strolled in my room with a retinue of about eight people, including his nurse, a resident neurologist who he was mentoring, and several medical students. “This is not exactly the place I would want to be seeing you,” said, perhaps a tad too glibly. “So, tell me what happened.” I told him that I had suffered a stroke at the Charleston airport.
” When did that happen?” he asked.
When I told him that it had happened nearly a week earlier, his response was not unexpected. “So, you admitted yourself to the hospital yesterday, five days after the stroke episode.”
“I assumed it was diakaeisis,” I responded.
Now, to put my response into fuller context, please allow me to provide a little background. In the year and a half that intervened between receiving Dr. M’s optimistic prognosis regarding the likelihood that I would suffer another stroke and the onset of my second stroke, I in fact experienced numerous attacks of what certainly seemed to be transient ischemic attacks, or “mini strokes,” When I brought these to the attention of Dr. M, he dismissed them as episodes of what he called “diakaeisis,” a fairly common phenomenon among stroke victims in which the brain, already traumatized by stroke, reacts to fatigue, minor illness, or prolonged stress by replicating the symptoms of a stroke.
Even after a follow-up MIR indicated that my dissection had not fully closed, Dr. M still felt comfortable with his approach to my post-stroke treatment regimen — doing no more than maintaining me on a blood thinner. I had read the literature on dissection strokes, and in most cases, Dr. M’s approach was the recommended one. Dissection strokes do tend to heal spontaneously. However, harking back to my “The patient knows best,” argument, the constant onslaught of stroke like symptoms demanded further intervention. Dr. M had alluded to the insertion of a stent to block the flow of blood in the area of the dissection.
In hindsight, I should have demanded the stent, even given the four-percent odds that it could trigger significant internal bleeding. Instead, I continued to complain about the frequent bouts of diakaeisis. At one point, I even checked herself into the emergency room, convinced that I was having another stroke. I was given a CAT scan (as opposed to more to the more discerning and costly MRI), which revealed no evidence of recent damage in my brain. What the scan did show, however, was that the tear in my carotid artery still had not completely closed.
A couple of months later, I pulled up in front of Evanston Hospital and contacted Dr M’s nurse, telling her that I was about ready to check into the emergency room because earlier in the day I had been in a state of near left-side paralysis. When she asked me how I felt at that time, I said that it had abated to the extent that I could leave work, get into my car, and drive to the hospital.
“The time to be concerned would be if you had a symptom like that and it did not eventually abate,” she responded. Crestfallen and relieved by about equal measure, I drove home.
If I may pick up where I left off, when I told Dr. M that I assumed my symptoms in Charleston were no more than diakaesis, his response, in typical Dr. M fashion, was sort of out in left field. “You know, what’s ironic is that when I got the news of your hospitalization, I was in Rochester at a stroke symposium,” he responded jovially. “Your case was actually on the agenda. “You are what we neurologists call a ‘head scratcher.'”
from what I recall, Dr. M explained that the none of the roughly 60 neurologists at the symposium could recall treating a patient with a dissection stroke who experienced numbness in other stroke like symptoms on almost a daily basis.”
What I wanted to say was, ” for God’s sake, as if though that wasn’t a cascade of yellow flags!” instead, I said something inane, along the lines of, “I guess I’m famous now?
Dr. M chuckled. “Time will tell.” ( In hindsight, what was that supposed to mean?)
if any encouraging news came out of our interview, it was that Dr. M, perhaps observing that the proverbial horse had nearly knocked the barn door off its hinges, decided to take a more aggressive approach to my treatment protocol: he would order the insertion of a stent, forthwith. The procedure will be scheduled for two weeks hence.
On Aug. 8, 1988, I received in the mail a note from my mom. This is how it opened: “Dear Tom, You have every right to trash this as I feel I am imposing on you. But some of the special characters in my childhood had such an impact on my life, its [sic] like they are urging to write this. It haunts me.”
When I reached Mom by phone, she reiterated that she felt compelled to write her life story. “I want to write the truth about my life,” she asserted, “so that no matter what you hear from people who claim to know me, you will know the facts”
A little background: I am the oldest of eight children. Upon earning a Master’s in Journalism at Northwestern University, I elected to stay in Evanston, Illinois. Although I was the only one of my brothers and sisters who lived more than a half hour’s drive from Norwood, the Cincinnati suburb where my father served as vice mayor, mom had insisted that I was the only one she trusted to transcribe her dispatches. Intrigued and flattered, I agreed to her proposition.
From that point, until 1997, when chronic emphysema utterly sapped her energy (she died in 1999), my mom’s installments arrived like clockwork. Riddled with misspellings and teetering on the edge of grammatical coherence, her life story would ultimately encompass more than 300 pages
I wish I could assert that I was equally diligent in transcribing her installments as they arrived, but in truth, I worked on them sporadically for a few months, and then just let them accumulate. I was caught up in all the busy work that defines a man, who, along with his wife, was trying to stake his career in the unstable world of journalism, while also trying to raise three boys.
When my father died in January, 2014, he left behind a rich private and public legacy It was that only then that I realized that my mother’s legacy, her life story, was solely in my hands.
She begins her account by asserting that she was fondled at age 11 by a priest at Saint Aloysius, the Cincinnati orphanage where she was sent along with her three older sisters, Rhody, Margie, and Jeannie. “He would put me on his lap and touch me, but Jeannie finally told Sister Margaret and then he stopped,” she writes.
With the exception of this shocking revelation, she has little to say about the four years she lived in the orphanage. She writes that although the nuns “lacked warmth,” they took pains to assure that she and her sisters always had clean clothes. She also explains that she and her sisters were placed in the orphanage because her mother had lost her job as a registered nurse when it was discovered she lacked proper credentials.
She was 13 when she and her sisters were released from the orphanage. They were reunited with their parents and resumed a more or less normal life. Their mother had found work as a caretaker for several elderly clients. Their father would disappear for days at a time, occasionally returning with small sums of money. (He was later struck and killed by a train under mysterious circumstances.)
Based on her writings, it would seem that mom’s years in high school were consumed by mad crushes on boys, Saturday night dances and one remarkable opportunity: She caught the eye of a fashion buyer at Shillito’s, flagship of Federated Department Stores, Inc., then a fledgling chain. “She [the buyer] said I had the statue (sic) and facial features of a model,” mom writes. “I told my mom I did not want to go back to school that fall because I had a good job. When I told her how much it paid she was all for it.” It was the start of a three-year career as a Shillito’s house model.
In her modeling head shot, she is a composite beauty — Rita Hayworth cheekbones, Judy Garland full lips, and thick, lustrous hair that she described dismissively as “dishwater blonde.” As a runway model for a store aspiring to break into high fashion,she had the opportunity to meet celebrities such as Bob Hope, Benny Goodman and Jimmy Durante.
It was during this time that she learned to dance under her sisters’ tutelage, asserting that she eventually became the best dancer of them all. However, still working as a model in 1946 and becoming increasingly dismayed by the demands of a job that offered little time for a social life (models were routinely enlisted to participate in charitable and promotional events), mom writes that after a chance meeting, she finally snagged a date with Tommy, “my high-school heart-throb, who still managed to show up in my dreams.”
The event was a midsummer dance at Moonlite Gardens, Cincinnati’s premiere dance venue. But, she writes, even as Tommy, witty and urbane, lavished her with attention, she couldn’t take her eyes off a dashing ex-serviceman who “danced like an angel.” That man, Bill Cosgrove, would become my father.
Their marriage had an inauspicious start. Mom describes the first night of their honeymoon as “horrible,” and largely blames Dad’s mother, Henrietta, for failing to teach dad how to treat a virgin. “It hurt so bad, I had to grit my teeth,” she writes, “and Bill honestly didn’t know why there was blood on the sheets.”
Now, here’s where it gets complicated. My Mom meets my Dad about one-third of the way into her life story, and it is he, not the childhood friends to whom she previously alluded, who wrests control of her narrative. I suspect that the “truth” she so desperately desired to bring to the light of day was the pernicious evil of “momism,” which the Random House Dictionary defines as “excessive adulation of the mother and undue dependence on maternal care or protection, resulting in absence or loss of maturity and independence.”
In other words, my dad, in the eyes of my mom, was an insipid momma’s boy.Indeed, Mom goes so far as to accuse Henrietta of pressuring Dad to divorce her, arguing that he married beneath his station.
Henceforth, it will be Dad, (and by extension, his frail but seemingly inexhaustible mother), who will “haunt” the remainder of Mom’s life story.
She chronicles increasingly dark years marked by undiagnosed bipolar disorder, which entailed numerous hospitalizations and subsequent electroshock treatments; a descent into alcoholism, and, ultimately, a seemingly miraculous recovery when the last in a long list of exasperated psychiatrists threw caution to the winds and prescribed a new and controversial treatment: lithium salts.
As an aside, one of my key memories of my childhood, was our move from the small, two-bedroom house in North Norwood, on the crescent of Indian Mound and Sheridan Drive, to the big, brick house on Glenside Avenue, walking distance from the sprawling Chevrolet/Fisher Body assembly plant that dominated downtown Norwood. As characteristic of many communities in southern Ohio at that time, the rich people lived on the “Hill,” while the poorer people lived in the “Valley.”
Although we no longer lived on the Hill, our new house, situated on a block dominated by modest ranch houses and two-flats, evoked wealth. With its majestic oak and beech trees, not to mention the blue spruce tree — thirty feet tall with an almost equal girth — in the front yard, and with its sprawling side yard, our house would become a magnet for nearly every kid in the neighborhood, particularly as mom “blessed” us with a new brother or sister almost yearly.
I can appreciate the toll this took on mom during those years. She writes of the unrelenting time and effort involved in housecleaning, laundry chores and meal preparation. Dad would go to work at Blue Cross every morning as mom began her round of chores. As a seventh grader, I recall running home every day at noon in the company of five brothers and sisters. (Mom insisted that Dad’s income could not support the $5.00 weekly charged by Saints Peter & Paul School for lunch.) Entering the kitchen, I recall gazing upon a small mountain of peanut butter & jelly sandwiches heaped on a serving platter. Complementing the sandwiches was a pot of watered-down Campbell’s condensed something or the other, which mom would ladle into our white, plastic cereal/soup bowls.
This was also around the time that Mom and Dad seemed to stop trying to conceal their arguments from their children. We had grow accustomed to hearing their muffled voices in the bedroom, usually sometime after 10:00 p.m., when they assumed we were asleep. But it reached a point where Mom would usher us through our bedtime rituals around 9:00, kiss us goodnight, and then head back down stairs. Five or ten minutes later we would hear some choice expletive emanating from Dad’s booming baritone voice. In contrast to my short-tempered father, Mom would initially come off as the voice of reason. However, a half hour or so into the argument, Mom would hit some sort of red zone, and literally start screaming. Dad would fall silent, whether in awe of his wife’s fury or because it was an opportunity to disengage and take a breather, I was never quite sure.
Mom writes, “This was around the time I started looking forward to the manhatan [sic] in the evening, only I was having it earlier.” Meanwhile, as she writes, “My dreams were slowly going down the drain.”
The drinking would escalate. “It got to all I could think about was my next bottle,” she writes. “One morning I ran out and walked to downtown Norwood and waited for the liquor store to open.”
My siblings and I share many anecdotes about those “dark” years, when a fairly reliable, if absurdly dysfunctional, pattern held our family in thrall — Mom goes on a manic binge, consumes prodigious amounts of alcohol, threatens or attempts suicide, has a “nervous breakdown,” goes to the hospital for “shock treatments, and then returns home, sober, well-rested, brimming over with love and remorse, and somewhat discombobulated by the two weeks of memory wiped out by near-daily rounds of electroshock therapy. Four or five months later: repeat performance.
Be that as it may, mom had the remarkable capacity to descend into the maelstrom of psychosis, endure repeated shock treatments, and rejoin her family, determined to do better, her conviction bolstered by her knowledge that her children were blessed and walked with the angels. Indeed, By the time I moved to Chicago in 1980, mom had been sober for years and seemed to have an amicable, if not warm, relationship with dad.
Henrietta’s death preceded my Mom’s death by only a few years (Grandma lived into her nineties) and I think I can objectively say that Mom and Dad truly began to appreciate each other once she was out of the picture. As I mentioned, Mom had stopped drinking, had finally stopped smoking, and had suffered only one mental health relapse when the same psychiatrist who originally prescribed her lithium tried to transition her to the mood stabilizer, Topiramate. (She went on. a two-day shopping binge, running up $20,000 in credit card debt). As her emphysema worsened, Dad had a lift installed on the stairway and also installed the two big tanks Mom needed for what had evolved into 24/7 supplemental oxygen therapy.
I was nonplussed to come across this 1983 entry. “Once again, I’m thinking of getting a divorce layer [sic] to show Bill that I mean business. But then it goes threw [sic] my mind. Who could I get? Bill is so well known and popular I wouldn’t stand a chance.”
Mom’s last entry wasn’t dated. She writes, “Tom, yesterday was a really bad day for me so I took one of [my brother] Johns [sic] cigarettes and the symptoms [of emphysema] came back worse than ever. I’m going to have to get more nicateen [sic] gum.”
Mom’s death at 74 initially devastated my dad. However, his transition back to the world of the living was remarkably swift. He played golf, lunched with his buddies, and reveled in the adulation and tributes to be expected of a man who starred on Xavier University’s basketball team, who came back from WWII with a Purple Heart, who rose to the upper corporate echelons during his 30 years at Blue Cross, and who served for 35 years as the highly regarded vice mayor of Norwood. He was a devoted family man who took great pains to ensure that his children, grandchildren and great-grandchildren would be taken care of to the best of his abilities. My dad’s legacy is tangible.
Conversely, my mom’s legacy is not all that easy to grasp. I can assure you that she will not emerge as one of those undiscovered writers who garner posthumous accolades. If I were to cobble her “life story” into some semblance of a cohesive narrative and publish it, I have no illusions that it would interest anyone beyond immediate family. However, the irony is not lost on me that I have considered myself a writer ever since mom first praised the illustrated “animal books” I created in third grade, and declared that writing was my special gift. Hearing that as a child made me feel as unique and special as it made me feel decades later when she entrusted me to chronicle the most intimate details of her life.
How can I describe her gift to us, make it tangible? Well, consider the terms of my father’s will. He had eight children and made a point of bequeathing exactly one-eighth of his estate to each of us. Now consider my mother. What I’ve discovered through conversations with my siblings is that mom managed in some near-miraculous way to make each of us — Mary, Bill, John, Theresa, Kathleen, Jerry, Luke and myself — feel like we were the center of her universe. No matter what stumbling blocks life threw in our paths, each of us held securely in our hearts the unshakeable truth that “Mom loves me best.”
Mom was “old school” in her conviction that, by natural right, the man is the head of the household. However, it would be presumptuous of me to say that dad won every battle, particularly those revolving around her children. For example, she stood strong against dad’s insistence that I be named William Thomas, Jr.
“Your name will be Tom,” she writes, “because, after all, Tommy was the boy I loved so much who somehow disappeared from my life but not my heart.”
Dad finally relented, taking her at her word that she had always vowed to name her first son after her favorite apostle, Saint Thomas.
An excerpt of this post was previously published in the winter, 2015, issue of After Hours.
I sat facing a felt-lined, black board with 20 rows of push buttons. A random button would light up and stay lit until I tapped it, at which point another random button would light up and stay lit until I tapped it. “Slap the Lights,” was a component of my “drive-ability” evaluation. My performance on “Slap the Lights, “along with tests conducted in a simulated driving booth (aka “Avoid Hitting Pedestrians”}, would determine whether Dr. L., director of physical medicine, would clear me to continue driving.
For the time being, I was practicing on the light board, gauging how many lit buttons I could slap in one minute. My best time was 70, but that was with my right hand only. Using both my stroke-damaged left hand and my right hand, my best score was 57. I was told by Jenny, my OT, that a score of 55 or above should be enough to put me over the hump, but she admitted that she was basing her prognosis on the several-dozen patients to whom she had personally administered the test. She could not tell me what Dr. L. considered a passing grade, because he had never shared that with her.
Be that as it may, I figured I might as well take the light board test and get it over with; this whole driving thing was causing me too much stress. I told Jenny I wanted to do the non-driving portion of the test two days’ hence, my next scheduled OT session.
Back in my room, Ron, my new roommate, was talking quietly to his wife Jennifer. The night before, Ron had confided in me that he had underwent coronary bypass surgery. “It all went well, and everyone assumed I would be out of ICU within three days,” he explained, “but lo and behold, on the morning I was slated to leave I realized that I was feeling a bit feverish. So what is my first thought? Oh my God, I contracted one of those antibiotic resistant bugs! Luckily, it turned out to be treatable, but almost a week went by before the docs felt comfortable transferring me out of the contagion unit, or whatever they call it.”
Ron’s story was disconcerting because I would be facing surgery in less than two weeks. After finally determining that my stroke management protocol needed a kick in the shins, Dr. M had put in an order for me to have surgery. An “intervention radiologist” would be inserting a stent in my neck, with the anticipation that, once inflated, it would seal off blood flow to the immediate vicinity of my carotid dissection. The last thing in the world I needed was to contract some sort of post-surgery superbug.
A little aside, dear reader. My primary caregiver would tell me about a year later that I apparently have a kick-ass (not his exact words) immune system after I mentioned that I didn’t recall ever having any sort of infection with the exceptions of the common cold or the flu, and possibly, mononucleosis. My layman’s explanation for this is that my immune system was bolstered by all the animal bites, scratches and stings I sustained as a kid, animal nut that I was, and still am.
I ordered lunch and tuned into the Caylee Anthony trial In a nutshell, two-year-old Caylee, daughter of Casey Anthony, was reported missing on July 15, 2008. The report was filed by Cindy Anthony, Caylee’s maternal grandmother, who, along with her mother, shared the Orlando, Fla., household with George Anthony, Caylee’s maternal grandfather.
Cindy Anthony told the 9-1-1 dispatcher she had not seen Caylee for 31 days and that Casey’s car smelled like a dead body had been inside it. An investigation was launched, during which time Casey gave detectives varying accounts regarding Caylee’s whereabouts including that Caylee had been kidnapped by a nanny on June 9, and that she had been trying to find her, too frightened to alert the authorities. Not surprisingly, Casey was charged with first-degree murder .
George Anthony was on the stand, looking very uncomfortable as one of Casey Anthony’s defense lawyers grilled him about his alleged affair with Krystal Holloway, a woman who had volunteered to help search for Caylee before her body was discovered.
Alerted, no doubt, by the telltale southern drawl of presiding judge Belvin Perry, who constantly interrupted the proceedings, a couple of nurses drifted into the room. I filled them in on the latest. “It seems that George is having to explain his relationship with that Krystal women,” I explained.
“He already denied having sex with his own daughter,” Gabby, one of my nurses, informed us.
“Father of the Year candidate,” I quipped. The nurses caught a few more minutes of the trial, leaving just as my lunch arrived. For a change of pace, I was having the Burrito Grande, along with French fries, a fruit cup, and a strawberry milkshake. I figured I had gained maybe five pounds over the course of my six days’ hospitalization.
After lunch I pulled out my copy of the US Department of Transportation’s perennial bestseller, Know Your Traffic Signs. My goal was to memorize them while the CNN trial coverage droned on in the background. I was glad for the distraction, when, about a half hour into my studies, Ron hollered over from his side of the room, wondering if I had finished, No Easy Day. Jennifer, who was still at his side, was respectfully quiet and attentive as he and I exchanged more anecdotes about our respective military careers.
Before I knew it, supper time had rolled around. I figured I would partake of the personal pizza one more time before I put into force my resolution to sample some of the alternative I items on the menu. After dinner, I settled in to watch Dear John, a love drama starring Channing Tatum and a young female actress whose name escapes me.
Dear John started out promisingly, with a grievously wounded Channing Tatum laying on the ground somewhere in Afghanistan. surrounded by his Special Forces buddies. However, the flick abruptly turned south when Staff Sergeant John Tyree feels compelled to reminisce over a woman he had met six years earlier, and with whom he was still madly in love
In contrast to the band of brothers compelled to listen to SGG Tyree’s parade of mawkish romance-movie clichés, I was free to fast-forward, which enabled me to watch the remaining three-quarters of Dear John in under seven minutes.
The following morning, feeling alert and refreshed after a nurse-assisted shower and a breakfast of French Toast and sausage, I checked in at PT to take my driving test. Assuming I passed this test, I would then take a road driving test with a driving instructor contracted by Evanston Hospital, who supposedly has expertise in evaluating physically impaired drivers.
Mastering the first component of the test was very similar to the light board test I described at the beginning of this post, with one difference: the moment a light flashed, I needed to depress a foot pedal mounted on the floor approximately where a car brake would be.
I should note that the left-side stroke I suffered had a devastating impact. I already knew that I could no longer play the piano with both hands, and that I could no longer jump or run. In time, I would discover that I could no longer wade my beloved Wisconsin spring creeks, no longer swim, no longer paint watercolors or tie flies. But one thing I could do with a left-side stroke is drive a car, as long as it’s an automatic. My right foot and leg were perfectly functional. As you might recall, I had driven to and from Coon Valley, Wisconsin, a 600-mile round trip, during the five-day span when I was still in denial about having suffered a major stroke.
Next on the agenda was the test that would assess my knowledge of the rules of the road, as demonstrated by my ability to identify the various signs. My game plan in preparation for this portion of the test was to first skim through the USDT’s traffic sign book, test myself on how many signs I knew from sight, and then go back and more thoroughly study the ones I missed.
In hindsight, the most positive thing I can say about this strategy is that the identification of road signs, whether in silhouette or with markings intact, is only effective if one can remain focused on memorizing the signs while resisting the impulse to glance up at the TV to see what’s going on with the Kaylee Anthony trial. I flunked the sign test by one incorrect response.
I retook the sign test and passed it, which left only the road test. And I should mention. The cost of this test is $470, out of pocket. On the assigned day of my test, I met my tester. “I’m doomed,” I thought, for no other reason than the uncanny resemblance he bore to a former boss, who, after nearly a year of baiting me, finally provoked me into saying something that met the corporate definition of “insubordination.”
My tester was small in stature with close-cropped hair going to gray, and a mustache to match. I easily could have found amusement in speculating whether he was trying to emulate deputy Travis, Junior (played by Robert Ben Garrant), from Reno 911, had not the stakes been so high.
“Hello, I’m Mr. Cunningham,” he greeted me with stilted formality.”And this is Kate,” he said, gesturing to a twenty-something woman standing by his side. ” Kate’s a physical therapist intern. She’ll be my extra eyes and ears, so to speak.”
Great, I thought, suddenly observing that Mr. Cunningham was wearing what appeared to be rather thick glasses. And then, I couldn’t help but wonder: What if this guy was half-blind and actually did need an extra set of eyes and ears? What if he was half-deaf to boot? I followed Mr. Cunningham and his seeing-eye girl out of the hospital. The only car in sight was a black Kia sedan, no doubt the car that would decide my fate.
“Step into the car, please,” Mr . Cunningham said, and then scrutinized me as I eased my torso into the Kia’s small interior and then struggled to lift my stroke-affected left leg over the door panel and into the car. To my immense relief, my entry into the car wasn’t pretty, but I was able to accomplish it in one take, so to speak.
I was instructed to exit the hospital, turn right onto Central Avenue, and continue driving west on Central until I was instructed to do otherwise.
I was on the road for less than a minute when Mr.Cunningham said, “So, tell me about yourself.”
“Anything in particular?” I queried, feeling nonplussed and a little annoyed, not so much by his request, artless as it was, but by my desire to concentrate on driving.
“You know, as the operator of a motor vehicle, you will frequently be transporting passengers, in addition to yourself,” Mr.Cunningham intoned. “Human nature being what it is, you likely will be conversing with them, so I’m curious about this: Can you talk to a fellow passenger and still maintain road awareness?”
I proceeded to give Mr. Cunningham the broad particulars of my life: marital status, number of children, occupational status, etc. Glancing over at him at one point and suspecting that he that he was not particularly interested in what I was saying, I leaned over my shoulder and asked Kate, who was sitting directly behind me, “So, how do like being an intern?
Kate squeaked out a startled, “Me?” followed immediately by Mr.Cunningham’s stern pronouncement, “Don’t converse with anyone but me.”
Stunned by his rudeness, I locked my eyes on the road. Moments later, Mr. Cunningham said, “Turn left here.”
“You mean get on I-94?” I asked, as I sailed by the I-94 entrance ramp.
“Yes. Mr. Cunningham replied.
“Would you like me to turn around and re-enter it?” I asked, incredulous that he had issued his directive at a point when I would’ve had to swerve across a lane of traffic to comply.
“Is that what you think you should do?” he asked.
“I do,” I replied, ” because that’s what you asked me to do.”
“Very well,” he responded.
I made a right turn on the nearest side street, pulled into a driveway, and carefully backed out. I noticed that both Mr. Cunningham and his intern were writing in their notebooks.
If we can pause for a moment, dear reader, I’d like to insert a brief missive regarding my personal relationship with the I-94 Eastbound entrance ramp. Even before my stroke, I had a pet name for this ramp: “Shit Chute.” when you enter this ramp, you will not see what is happening on I-94 until you are less than 70 feet from where it merges into the interstate proper. Meanwhile, the westbound exit ramp for Dempster is only one-eighth of a mile ahead of you. Here’s The end result of this less-than inspired bit of engineering whimsy: motorists who realize at the last moment that they need to exit at Dempster East; motorists who think they want to exit at Dempster East, but who in fact really want to exit at Dempster West; and motorists who legitimately do need to exit at Dempster East, which compels them to merge onto the the same lane that you are using to enter the interstate.
This time I had to turn left to enter the ramp, but then I noticed that several people – a man, a woman, and two children — were walking along Dempster, just off the curb, and were just seconds away from walking across the entrance lane.
“Better wait for those folks to get across,” I said aloud. A moment later, I was startled by the bleep of a horn. “Easy dude,” I mouthed into the a rear view mirror when I realized it was the driver behind me who had honked his horn.
“You’re clear now,” Mr. Cunningham offered helpfully. I worked my way cautiously down the ramp, realizing that the oncoming traffic was fairly heavy. I’m going to ease in slowly, I said to Mr. Cunningham.
Once on the interstate, I was nonplussed when Mr. Cunningham directed me to take the next exit. He then directed me to pull into a strip mall. “This is the halfway point in our evaluation when I usually offer feedback as to how it’s going.” He turned toward the back seat and said,Would you like to begin, Kate?”
“No, you go ahead,” was Kate’s courteous reply.
Mr. Cunningham flipped through a couple of his notebook pages and then delivered his verdict. “Rather than dwell on the individual things I observed — your confusion when I asked to get on the expressway, your tendency to talk to yourself while you drive, your inability to smoothly merge into traffic when you entered the expressway, the fact that you failed twice to stop for a full three seconds at stop signs — I would feel more comfortable addressing an overriding global issue.”
WTF!?! I felt deeply insulted. Given the inherent stress of the situation, I thought my driving certainly passed muster. And what did he mean by “global issue?”
Before I could gather my wits, Mr. Cunningham elaborated. “Operating a motor vehicle involves thousands of complex bits of sensory input flowing back and forth from the brain to the eyes, ears, and muscles. In time, unimpaired drivers intuitively integrates this input. Driving becomes relatively effortless. But a driver with an impairment, even a relatively minor impairment, now has fault lines that have opened along this network. So the goal of physical and occupational therapy is to identify these fault lines and find ways to compensate for them.”
At this point, Mr. Cunningham leaned over and asked Kate the intern if she agreed with his analysis.
“I think so,” she concurred. ” Mr. Cosgrove does seem to be overwhelmed with all the sensory input. Based on what I have seen of his driving, I can’t say he has done anything that’s actually frightened me. But I would recommend another round of physical and occupational therapy.”
At that moment, it did not occur to me that the outcome of another round of physical and occupational therapy would dictate a a retest, and hence, another $470. Instead, I asked, “So, are you telling me that I failed my test?”
“Not at all,” replied Mr. Cunningham. “Like I said this is the halfway point. I will give you a full evaluation when we return to the hospital.”
In fact, we made a beeline straight back to the hospital. At one point, Mr. Cunningham observed that I was hugging the centerline, something he claimed I had a propensity for doing. “Here, let go of the wheel and let me show you where you should be.” He then proceeded to ease the car a little to the right. “Isn’t that better?”
” I suppose,” I replied, barely disguising the note of exasperation in my voice.
Needless to say, once back at the hospital, after consulting privately with Kate, Mr. Cunningham delivered the bad news. In addition to the flaws he had already mentioned, he added a new one: difficulty in staying in the proper lane. He reiterated that another round of physical and occupational therapy would probably enhance my ability to pass the retest.
Did I think I was an impaired driver? Hell no! And I had no intention of shelling out another $472 to support Cunningham’s racket.
In my haste to post my “Let me Drive” installment, I neglected to break up the miles of scrolling text with any graphic elements, or “art,” as we called it in the magazine business. So here’s a hodgepodge of mainly fishing photos and a couple of fun shots of sisters, Mary, Theresa, Kathleen, honorary sister Karen Cosgrove (brother Bill’s wife, and son Chris’s wife, Chihiro, and wife, Suzanne.
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.
It’s three days before my birthday, and I’m sitting in my hospital bed watching Caylee Anthony trial coverage on CNN. Prior to my stroke, I had never spent the night in a hospital. What the nurses are telling me now is that I should be thinking in terms of weeks, not days, before I am discharged.
The trial is weirdly compelling.The state of Florida is charging Casey Marie Anthony with first-degree murder in the death of her two-year-old daughter, Caylee. Casey has finally fessed up about the numerous lies she told authorities.Among the supporting players in the sideshow are Casey’s mother, who first reported Caylee missing, telling police that Casey’s car smelled like a dead body had been inside it; and Casey’s father, who, in a bizarre twist is now on the stand denying that he habitually sexually abused his daughter.
In the name of accuracy, I should backtrack. Throughout the night I will have been awakened bi-hourly by one of two night-shift nurses to take my “vitals.” The mortification they both profess to feel by virtue of having to disturb my sleep appears so heartfelt that I routinely reply, “I was actually not even asleep, but only engaged in quiet meditation,” or words to that effect.
Anyway, my anticipation of seeing my nurse, whoever she may be, is heightened by the prospect that I may be asked if I would like to shower; Gabby had asked me yesterday morning. Here’s what a shower entails: an “assisted” disrobing, a delightful post-shower rubdown with what passes in hospital lingo for a “towel,”
followed by an “assisted” re-robing with a clean, starched hospital gown.
Lori comes breezing in. “Good morning, Thomas! Howya doin? (Lori was born and bred in Somerset, Kentucky. I explain to Lori why Mr. Anthony is on the stand, which elicits from her the observation that “A lotta strange people live in Florida, doncha think?”
I am of the notion that lots of strange people live in every state; nonetheless, I heartily endorse her contention.
I am on the verge of speculating whether Lori might find time in her busy schedule to assist me with a shower, when she suddenly announces, “I’ve got some great news for you, Thomas! You are going to start your physical therapy today!”
“That is great news,” I reply, but then, after one of those, “pregnant pauses,” I slip in a desultory, “I suppose.”
Lori turns serious. You have about a six-or-seven-month window to recover as much as possible of what you’ve lost from your stroke. That’s what all the data says..”
Of course, I already know that physical therapy is paramount to both my short-term and long-term prognoses.Indeed, I am already aware of my limited window of recovery, during which time undamaged neurons can still forge new pathways that can at least partially accommodate parts of my brain where tissue has been destroyed. Reflecting on the wonders of neuroscience does not dilute my desire for an assisted shower
Will I get that shower? Well, I hate to keep you in suspense, but when it dawned on me that mote than a month and a half has elapsed since my last post, I vowed to publish at least something post haste, as it were. So here is my modest offering (
The Free Dictionary defines the idiom, “fits and starts,” as, “irregular movement; with much stopping and starting.,” which perfectly encapsulates my progress on the eighth installment of “My Stroke.” With the working title of “My Rehab,”this particular chunk will cover the three weeks I spent in the hospital following my second stroke.
As chunks go, this one is big, covered with gristle, and very Iikely I will encounter a bone or two lurking in it. This was a time of botched operations, malfunctioning IV monitors, horrific bedpan misadventures, and a concerted effort by my physical and occupational therapists to strip me of my driving privileges. It was during this time that my neurologist, Dr. M., discretely dropped me from his caseload. Weeks would pass before I realized he had opted to no longer be my neurologist.
Daunted but not defeated by the challenge of putting into words this momentous, not to mention traumatic, time of my life, I am aware, nonetheless, that more than a month has elapsed since my last posting. Hence my plug-the-gap strategy of posting this hastily compiled selection of photos, some new and some previously published, that I’m hoping might lend a little more contextual texture to my life and times and circumstances, so to speak.
According to the Centers for Disease Control and Prevention, every year more than 795,000 people in the United States have a stroke. Of these, about 610,000 are first-time strokes. Stroke has an eerie similarity to Russian roulette — drop a round into the cylinder of a six-shooter, give the chamber a good spin, hold the gun to your head, and pull the trigger. You have the same odds of blowing your head off as of suffering a fatal stroke over your lifetime: 1 in 6.
I feel positively blessed that I can still teach, still drive (provided there’s no clutch involved), and still whip through crossword puzzles.
Here’s what I can no longer do: play piano, wade trout streams, tie flies, tie my shoes, garden, hike any terrain more challenging than a gently sloping sidewalk — and, considering how much time I spend around the water, I can no longer swim.
I suffered my first stroke, a right carotid artery dissection (or tear) in 2010. The neurologist on call at that time, Dr M, promised a full recovery. His prediction was spot on. I spent three days in the hospital, breezing through a physical therapy evaluation, and generally feeling like I had been given a new lease on life.
To say I was euphoric would be an understatement. A month after my release,I played piano in the Jewish Child & Family Services All-Star Band, fronted by JCFS CEO Howard citron, who led us through a rousing rendition of “Sweet Home Chicago.” I made a couple trips up to Coon Valley where I waded trout streams to my heart’s content. I weeded, cut the grass, and on a couple of occasions, even took out the garbage.
But then came the reckoning. Near the end of August, I had my first encounter with “diakaesis.” As Dr. M. had explained to me back on Easter Sunday, “A stroke is a violent, completely unexpected assault on your brain.” Consequently, he explained, it is not uncommon in stroke victims for the now shell-shocked brain to interpret events such as stress, lack of sleep, or respiratory illness as an impending stroke. The brain then responds by replicating the symptoms of a previous stroke.
How then, I asked Dr. M, will I be able to tell the difference between diakaesis and an actual stroke?
“If it is diakaesis, you will feel symptoms in the same areas where you had your stroke, and the symptoms will be of short duration.” he replied. However, he urged me to call 9-1-1 immediately if the stroke-like symptoms last longer than a couple of minute, or if I experience “stroke-like” symptoms in an area of my body not previously affected by my stroke.
When discussion turned to post-stroke treatment, Dr. M. mentioned, almost as an afterthought, the option of a stent insertion. Popular as a means of widening clogged arteries, stents also have been inserted in the vicinity of carotid artery dissections to seal off or block blood flow.
To perform the procedure, a “radiological interventionist” makes a small opening in a blood vessel in the groin, arm or neck. Through this opening, the interventionist threads a thin, flexible catheter with a deflated balloon (the stent) at its tip. Using x-ray video, the interventionist directs the catheter to the area of the dissection, where the stent is inflated. The catheter is removed but the stent remains. Over time, arterial cells grow to cover the mesh of the stent, creating an inner layer that looks like the inside of a normal blood vessel.
But stent placement, or carotid angioplasty, has a downside, Dr. M. cautioned. “It’s not as invasive as, say, a carotid endarterectomy, but it carries about a six-percent risk of triggering a stroke during the procedure.”
Dr. M’s advice? “You could call me a conservative, I suppose,” he counseled, “but I put great stock in the body’s ability to heal itself, and dissections generally close on their own. I want you to check in with me in eight weeks for a CT scan, so we can eyeball it.”
I felt relieved and reassured. I took an immediate liking to Dr. M., who appeared to have quickly picked up on my quirky sense of humor and was only too eager to respond in kind.
Spoiler alert: Dr. M. eventually reached the conclusion that my stroke prevention protocol could be enhanced by a more invasive approach. He reached this conclusion In July, 2011, after I twice checked into the emergency room, convinced that I was suffering a full-blown stroke; after I repeatedly hounded Dr. M’s nurse (Dr. M. was never “available” to speak to me by phone) to please inform the good doctor that I was having episodes of diakaesis almost daily; after Dr. M. viewed MRI imagery taken six month after my stroke and acknowledged that the tear still had not closed (“Not to worry, it doesn’t have to close.”)
Are you following me, gentle readers? Dr. M. concluded that my stroke prevention protocol could be enhanced by a more invasive approach right at the point when I was simultaneously suffering a second stroke. Three botched carotid angioplasties and one botched carotid endarterectomy later, I was pretty much right where I started from. Speaking as a layman, I can confidentially state that, if polled, most doctors would circle, “When the patient is actually having a stroke,” in response to the question: “When is the worst possible time to implement a stroke-prevention action plan?”
Incidentally, what I like to refer to as “the icing on the cake” occurred in post-op where I was recovering from the botched endarterectomy (the surgeon had said he encountered too much turmoil in the vicinity of my stroke to risk attempting to stitch the tear.) Around 11:30 p.m., about 12 hours after my surgery, a malfunction occurred in the pump administering intravenous heparin, a powerful blood-thinner intended to discourage clotting around my carotid tear. Suddenly, I was receiving so much heparin that my blood was permeating through my surgical stitches in a sort of micro-mist and pooling in my neck .The only way I can describe the pain, which steadily grew worse, is that it felt like some force was inflating my face from within, and would continue doing so until my face burst open. I pushed the call button to no avail. Finally, I worked my way out of my bed, and crawled to the door, where I beheld a hallway, deserted and dark but for the dimly lit nurses’ station about 100 feet distant.
I could go no farther because my IV tubing was stretched to the limit, so I just lay on the floor, crying and screaming. At some point I caught the attention of a nurse. “You absolutely should not be out of bed,” she scolded as she approached me.”Something’s wrong!” I croaked. “I’m in unbearable pain!”
“I’ll be right back,” the nurse responded, and then she left!
I was deep within the palace of pain when the nurse returned with the ER resident on call. “The Heparin monitor malfunctioned, ” he informed me. “You were getting an excessive amount, so we cut it off.” He spoke in a soft cadence with a British inflection. He had a courtly manner remarkably similar to that of a former co-teacher of mine, an emigre from Ghana.
Several medical personnel hovered around the doctor. He turned to one and said, ” Two milligrams of hydromorphone, IV, please.”
Then he turned to me and said, “We’re giving you diluadid, a powerful painkiller. Soon, your pain will become more bearable.”
“Mgeto” was the name engraved on the the doctor’s ID badge. As the narcotic moved like a soft mist through my body, enveloping and then smothering the jagged shards of pain, I made a vow: Should I last the night, I will do all in my power to ensure Dr. Mgeto’s canonization into sainthood.
But, my dear and patient readers, I have been digressing! So please allow me to take you back to where we last left off: I’m referring to my post, “My Stroke, Part VI), at which point Dr. M urged me to make my way to the Evanston Hospital Emergency Room post haste.
As a “second-timer,” I knew the drill: Tell the security guard at the ER entrance that you think you’re having a stroke, at which point you will be whisked through the waiting area, where you’ll attract the mild curiousity of the two-or-three-dozen souls who won’t be going anywhere soon. The big curtain will be pulled open and you will enter the inner sanctum, where you will be wheeled into one of the partitioned alcoves, at which point it will occur to you that, akin to those jerks who, entering construction zones, drive all the way up to the the point where the two lanes funnel into one, and then commence trying to bully their way back into traffic, you, too, have come barreling out of nowhere to bump everyone else down a notch.
Within seconds, you will find yourself in the company of nurses and technicians whose smiles and well wishes are unforced because this is just another day at the shop for them. By the time Central Registration shows up to formally admit you, it’s probable that you’ve already been hooked up to the monitoring machine, along with an IV drip, and that you’ve undergone the stroke assessment protocol (“Do you know where you are?” “Give me a big smile.” “Squeeze my finger as hard as you can.”)
Next came a CT (or computer tomography) scan, the quickest means of getting a sense of what exactly was going on inside my head.
My acknowledgement (which, I suspect, in the minds of the assembled hospital staff was tantamount to a confession) that I had waited nearly a week before seeking medical help for what the MRI images from the previous evening clearly confirm was a stroke, ruled out an injection of a “clot buster.” Alteplase, the only drug approved by the FDA for stroke treatment, is a tissue plasminogen activator that hones in on blood clots anywhere in the body and “busts” them up. However, altiplase is only effective if administered within three to four hours after a stroke.
Consequently, all my assembled stroke team could do was to fit me with inflatable, plastic socks designed to promote circulation in my feet, and withhold my blood pressure medication, based on the premise that increased blood flow discourages blood clotting.
I was admitted to my room to get what rest I could, and to await my visit with Dr M, who was expected at about 4:00. It was now about noon. My roommate, a gentleman who looked to be in his sixties, in the company, I assume, of his wife, was already eating lunch. Judging by his wife’s slender frame and fashionable garb, I assumed they hailed from Wilmette, an upper income community just north of Evanston. The couple studiously ignored me, seemingly immune to the racket created by the orderly wheeling in my bed and by the nurse-on-call as they got me settled in.
“Looks like lunchtime,” I ventured. Actually, I was famished. Aside from the fact that I was wearing plastic “socks” that rhythmically (and rather nosily) inflated and deflated, and that I was horizontal with a cluster of IV tubing snaking from my forearm to various monitors, I felt completely okay. And, as I mentioned previously, I was seriously hungry.
So far, no response. I gave it another shot. “Excuse me,” I said rather loudly, “Does having a stroke cause an increase in appetite?”
The nurse-on-call, who was stooped over beside my bed jiggling with one of the controls, popped her head up and said in a cheerful voice, “It certainly seems true in your case! What would you like, sweetie?”
I knew exactly what I would like: “A pepperoni-and-sausage personal pizza, a strawberry shake and a Chocolate Lover’s brownie.” Those menu offerings were the highlight of my previous stay.
The nurse-on-call flashed an almost-cartoonish pout. “Oh, honey, your doctor would like you to order from the Healthy Heart menu until he gets the chance to meet with you.
Now you decide to get proactive, Dr. M., I muttered under my breath. Take away the one thing that could have brightened up this totally shitty day.
While enjoying my baked-chicken sandwich, mashed potatoes sans butter, bowl o’fruit, Mountain Dew (How did soda pop slip through the cracks?), and Berrylicious pudding, I found myself glued to the overhead television, slowly getting sucked into what I overheard one of the nurses refer to as the “Cayley Anthony Trial.” When Dr. M. strode into the room four hours later, I was almost annoyed. The stepfather had just taken the stand.