STROKE

RUTHANNE URQUHART


In the depths of winter I finally learned
there was in me an invincible summer.
Albert Camus



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part THREEThroughout my recovery in hospital, I dealt with a variety of doctors, RNs, RNAs, lab technicians and therapists. They were compassionate and very good-humoured.

The end of the Sixth Floor I was on was unofficially designated the 'hands off' section: we were all either well on our way to recovery and discharge, or expected to be so shortly. I spent more time with the staff on a social basis than I did for medical reasons. Being hospitalized in my home town meant I'd gone to school with one RN's brother; a lab technician was a childhood friend; a physiotherapist was married to my first childhood boyfriend. At that time, I was the only patient on the Sixth who was (relatively) young (37) and so had interests similar to their own. My off-the-wall sense of humour allowed me, and therefore them, to laugh at the ridiculous, genuinely funny aspects of my predicament.

My mum later told me she would get off the elevator and hear the laughter coming from my room, and know that someone was taking her break with me. I knew whatever went on during these sessions would be duly recorded on my chart as evidence of good emotional health, a stable outlook, etc., but it was fun, too.

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When I was free to use the wheelchair at will, I was determined to get myself to the bathroom and back alone, blissfully alone. Getting from the bed to the wheelchair was easy; with a few side trips into the furniture (paddling a canoe without switching sides) the bathroom was achieved. Even manœuvring the chair beside the toilet was okay; I'd always been good at tight parking.

And it was bliss. I hummed. I stretched and scratched and contemplated. I did everything we do when no one is waiting and watching and taking notes. I finished in leisure, and arose with the lurch needed to do so when strength and sensation are one-sided. I lurched too hard, and slowly, inexhorably tipped forward until my forehead met the wall opposite the toilet. There I stayed, bare bottom stuck out behind, feet anchored in clothing and paralysis, sliding a bit more to the right every time I let go of the safety bar beside me to try to right myself. I cursed and laughed and slid until I had no choice but to pull the bell cord.

When a nurse arrived, I turned my head enough to look at her and say, "Don't you dare laugh. Just tip me back..." But she was off, leaning on the door frame, arms wrapped around her middle, howling. "No, I can't lean here long enough for you to get the girls. Just tip me back, damn it."

She did, still laughing, and headed back to the nurses' station. While I pulled up my dignity, manœuvred out of the bathroom and pinballed back to bed, I could hear the laughter, echoing my own, from the nurses' station.

There wasn't a lot of laughter on the Sixth; it sounded good.

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Once I was wheelchair mobile, I was allowed to leave the hospital for short jaunts with the ubiquitous "responsible" person – in my case, my husband.

The first time he took me home for a visit, I was ecstatic. And yet, I was amazed by how quickly I had come to accept the hospital as home, and by how nervous I was about leaving it. Everything outside those walls seemed so wide, so high, and so potentially injurious. Everyone walked so quickly, turned so abruptly, talked so loudly. Although I had felt overwhelmed at times in the hospital, I could pull the curtain around my bed there, and everyone understood. Suddenly, I was re-entering a world where I couldn't lie down, didn't have a curtain to pull and, most importantly, where nobody understood.

I overloaded. Too many stimuli (visual, aural, emotional) caused my brain to shut down. That shutdown was involuntary and lasted virtually the whole outing. I couldn't think, concentrate or respond, not because I actually couldn't do those things, but because my damaged brain needed a lot more time than the world was willing to give it. When that necessary time wasn't forthcoming, my brain simply gave up and shut down in self-defence. I don't remember anything about that first outing except my sense of relief at returning to the hospital.

Weeks into my recovery, mum and I were leaving the cafeteria one day, and we ran into (no, not literally) an elderly woman from the Sixth being wheeled in by her husband. She had been in hospital for some time, unable to understand or communicate, I had been told by the nurses when I asked.

I said "Good morning" to her, and then just sat and daydreamed while mum and her husband chatted. About 30 seconds later, she smiled and said, "Hello". Her husband was astounded.

I was heartbroken. Her belated response carried me back instantly to the early weeks of my recovery, when a nurse would enter my room. "Good morning. How are you this morning? It's a beautiful day. I hear your husband's good-looking. The night nurse saw him. I met your son yesterday. He's a doll. And your daughter's so pretty..." Through all this, my damaged brain was still trying to figure out how I was that morning, and by the time it had formulated an answer, and I spoke it, she was gone, no doubt noting on my chart that I was unable to understand or communicate.

I sat and looked at that lady, watching her try to absorb and process the noise, the movement, the questions, the speed with which everything happened, all with a brain made ponderously slow, with a mind prone to misfires caused by her stroke. I was fortunate. For me, that constant overloading of the senses and the resulting shutdown of my brain had lasted only weeks, not months.

My heart went out to her, and for the duration of my stay at RVH, I tried to talk with her every day. It was a slow process; a short question or comment from me, and a long wait for what would always be a succinct, sensible, appropriate response from her. The nurses observed us talking and, I'm certain, revised their chart entries for her, but they couldn't take, didn't have, the time for such ponderous conversations.

Silence can indeed be golden, and ever after I was very appreciative of the kind people I talked with who would take the time to allow us an actual conversation.

My husband took me home for several more visits, he told me later. I don't remember. I guess I shut down immediately. I probably dreaded my permanent homecoming, whenever that would be, knowing I would not be able to cope with anything at all, fearing I wouldn't be able to shoulder the responsibilities.

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I was scheduled to have my hearing tested one morning. A volunteer worker arrived to wheel me to the clinic, and she gave me my chart to hold on my lap along the way.

I was surprised (a patient is not supposed to see her chart) and delighted (I am nosy, especially about myself), so the whole long way there and back again, I read my chart. The volunteer didn't seem worried by this breach of the rules.

And why should she have been? To this day, I can clearly remember my glee at the reading, but not one blessed word I read.

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Many people visited me while I was in hospital. Some visits I remember; for others, I rely on my mum's memory. Again, I was puzzled for a while by this seemingly arbitrary forgetfulness.

In early June, not long before the stroke, I missed a family wedding because I was helping my brother-in-law care for my newborn niece while my sister had surgery. Some time into my recovery, the recent bride brought her wedding photos to the hospital to show me. I tried to explain that I was still seeing double, but she and her mum wanted me to choose a photo to be enlarged as a gift for my husband and I. I remember clearly the blur of photos, the exhaustion I felt trying to choose. Ultimately, I chose at random. I remember that visit not because it was pleasant (although initially it was), not because I was glad to see them (although I was), but because it took me the rest of the day to recover from the overloading.

The same week, my mum tells me, I had a visit from a good friend of my mother who was also one of my horticultural society friends. We chatted for half an hour or so, we laughed, we had a good time... according to my mum. I don't remember the visit at all. Our friend's visit was no more or less pleasant than that of the bride and her mum; I was no more or less glad to see her than I had been them; it's just that nothing remarkable happened. It was a visit that caused me no exceptional stress and no exceptional delight, and so my overtaxed brain chose not to retain it.

Although I didn't know it at the time, I have come to recognize that single-mindedness as a common state among recovering brain injury patients. Indeed, it can be found in anyone recovering from any serious illness or injury, anyone who is completely preoccupied with one new activity: we all recognize and accept first-time parents as folks who breathe, eat, sleep and talk nothing but baby for weeks and months. As do many stroke patients, I reacted to my recovery in that same single-minded way: anything that impacted upon it, whether positively or negatively, was retained; everything else was not.

In fact, that single-mindedness served me well during my initial recovery. It helped me to deal with physical inabilities with strength and determination and, I'm certain, helped me to overcome those problems more quickly than I might have otherwise.

Unfortunately, that kind of single-mindedness is often perceived as selfishness, insensitivity or self-pity by onlookers. When I was home again, much later on in my recovery, I was disheartened to learn that husband and children did indeed regard my singlemindedness as all of those negative things. Unhappily, by the time I came to that understanding, a great deal of damage had been done within my immediate family.

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The ladies on the Sixth, most of them much older than I was, would often pat my hand and smile at me with "aren't you just the cutest thing" smiles on their faces. I'm really not a cute personality, and I couldn't figure it out.

One day, one of them confessed that they all thought it was so sweet because, according to my roommate, I giggled in my sleep. I still couldn't figure it out, and didn't until that evening after "lights out", when I lay behind my curtain wearing earphones and laughing at The Golden Girls, all eight of them.

I must confess, I never told the ladies on the Sixth.

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