Friday, March 27, 2009

A Continuation of Brooke's Narrative, begun last February

Here's a continuation of the narrative Brooke has been writing, begun last February:

To continue where I left off in the ICU. I must have been highly sedated. But you can imagine my surprise when I found myself with a tube down my throat unable to speak except with a silent, painful voicing. Faces kept flickering before my eyes, my wife, Peggy's, my sister, Lisa's, my stepdaughter, Sara's, my step son, Mike's, my sister-in-law, Sally's. I dimly recognized these faces and the voices that came from them. At one point, I remember asking Sally, what happened, why I was there. And she told me in her soft voice that I had had an accident, that it was serious, and that I was in the hospital, in the ICU. Nurses kept appearing and what I later understood to be respiratory therapists, who suctioned me hard, pushing something painful down my throat, sometimes using pulsating machines that I later learned were supposed to be dislodging secretions in my lungs. As became evident, I had pneumonia; my lungs were filled with mucus that had to be sucked out five times a day. I concentrated on the faces of these therapists, I learned their voices, I studied their eyes, their ears, their noses. I silently asked their names, and those who could read my lips told me who they are and who they were. I tried to strike up conversations. Some of them I met later in Rehab, and I remembered them from earlier in the ICU. That was a strange experience, to have somebody's voice back after several weeks, their faces, their beards, their earrings, the tones of their voices. I don't know how many times I was suctioned during the week or so that I was in the ICU. It seemed like hundreds. The nights were especially intolerable, and I dreaded them. At one point, I coded out, which means I lost my pulse, my heart stopped. I recall the nurse, with whom I’d struck up a close relationship, pumping my chest hard, time after time. After it was all over I recall someone asking the nurse if he needed anything. And he said, "a Valium."

I said, the nights were intolerable. They were intolerable, mostly because I had no way of contacting a nurse if I were in trouble. The ICU for some reason had no mechanism for doing this for someone who couldn’t speak and couldn’t shout and couldn’t use their hands. First the nurses taped together a “sip-‘n-puff” straw to blow into or suck on to notify someone, but it didn’t reach far enough over to my mouth; then they taped the straw to my cheek, but this left abrasions on the skin on my cheek when they ripped it off; then they devised a construction of two straws taped together, but this was almost as flimsy as the first. I had feelings of deep insecurity that overrode whatever drugs they gave me to try to treat the anxiety.
Furthermore, I had nothing to distract me during the long nights until Barry Weller and Howard Horwitz bought me a CD player. I listened to something by Schubert over and over again every night. It got me through. The other thing that got me through where the faces of my wife Peggy and the hands of my daughter Sara, who kept pressing them to my forehead and asking me to relax, relax, relax. Before she left for Seattle she would put her fingers on my forehead and said, over and over again, softly but firmly, "be strong for me, be strong for me." Remembering those words has gotten me through a lot of rough periods over the past three months in the hospital.

Faces began to flicker by again, colleagues I knew from the English department. They came by in droves, face after face. Their presence overwhelmed me. I couldn't speak. I could only look thankfully at their expressions of concern and solicitude. To me some of them just seemed curious to see me in the condition I was in. That may seem unjust, but many of them I have never seen again. That may sound bitter, but I know that if I were in their shoes I might do the same thing, just make one visit to a sick friend. How many times have I failed to visit friends in the hospital when they were sick? The question haunts me now as I lie here in Rehab.


I tried to make the visitors feel comfortable, but sometimes it led to various kinds of awkwardness. What could they say to a colleague who has been paralyzed from the shoulders down? I think if I were in their situations I would have felt awkward as well. Do you reach out and touch him? Do you ask How are you doing? Do you tell him what is going on in your own life? All these are difficulties for anyone who is visiting someone who is very ill or injured in the hospital. There were difficulties for me, too. How could I make them feel comfortable in my presence, when I must have looked so wretched in their eyes? A once-healthy person reduced to total immobility, with IV lines running into his arms and tubes sticking out of his throat?
And what do I say to them? Early on, I had only a signboard—a big sheet of plastic with an alphabet written on it in magic marker. I could point to the letters by holding a straw taped to a tongue depressor that had adhesive tape wrapped around one end; I could hold this in my teeth, but it was an extraordinarily tedious process to spell out words and rarely actually worked very well; people still had to guess at the words I was trying to make, and we all grew impatient.

Three or four episodes stand out in my memory of the SICU. One is when I suddenly realized that I had no feeling in my hands; up to that point I thought I might be paralyzed but still had sensation; I didn’t realize how serious it was. That’s when Mike explained to me the nature of the accident. Believe it or not, a line from Keats’ Fall of Hyperion flashed into my mind:

The feel of not to feel it, that was never said in rhyme.

The young poet is being initiated into the mysteries of human suffering. He has to ascend a staircase to arrive at the mysterious goddess Monita, who contains in her skull all of human suffering through all of the ages. Before he can ascend, however, he has to feel what death is like. He stands on the steps at the bottom of the immense staircase and feels the coldness of death move from his feet up his limbs, until it reaches his hands. He grasps them, and the line that follows is the “feel of not to feel it.” That line suddenly meant something to me in ways that it never had before. The feel of not to feel it—that was what I felt at that moment. My suffering was going to be a drop in the bucket compared to all the human suffering experienced by people throughout human history, but still, it was going to be a suffering nevertheless, and I realized that at that moment.

After I’d been in the SICU for a few days, I had a visit from John Paul Brophy, who is also the victim of a spinal cord injury that he had when he was 20—he used to come to my classes in a wheelchair. As it turned out, he was the owner of the Dead Goat Saloon, where Peggy and I used to go in the evening and dance to wonderful bands. John Paul would sit there in his wheelchair, and one night I came over to him and sat down and asked him how he was injured. He told me that he had had a motorcycle accident—a car collided with him when he was 20—and he was in the hospital for months, in a body brace. This was thirty years ago, when technology was not very good. John Paul appeared as if out of a dream, because I had been thinking about him in my hours alone at night, and how ironically I would now be in the same situation as he was when he was my student. He told me he had heard about my accident from his sister-in-law, who works in the ICU—I remember that he said, “I never thought that I would see you this way.” Later, John Paul’s appearance on that day seemed to me to be a fiction of my imagination, it was so strange, but he has just visited me again out at South Davis, where I am now. So it wasn’t a dream. John Paul has been very important to me over the past months. He’s walking now, with a cane, and the wheelchair is gone.

The third event was when Peggy and I were together alone, crying together, and I said, spontaneously, or rather mouthed, spontaneously, since I couldn’t speak at that point, “we can still have a wonderful life together.” And she responded, yes, we can.

And we are, even now. At this moment, four months after the accident and three and a half months after the time in the intensive care unit when we said those things to each other, we’re sitting together in the extra wide, extra long low-air-loss special hospital bed at South Davis. It’s hard to describe the revelatory and liberating nature of that moment in the ICU for both of us, that despite what might seem to be an utter tragedy, we can still imagine something beautiful emerging from it. We keep thinking: this is only a tragedy if we make it that way.


Lorraine Seal said...

Anxiety in the night: My friend’s brain injury destroyed his short-term memory along with his judgment and other cognitive functions. In the beginning, certainly, he was not sure what was wrong with him, where he was or why he was in a strange place. He was desperate to escape and to recover his freedom. Not a good sleeper even before the injury, now he was extremely restless in the night, bewildered by his surroundings. When the meds would wear off, he’d bolt from his room, searching for the route to escape the danger.

I could joke, as one would, that you could tell him (let’s refer to him as R) the same story over and over, because he never remembered it. You do look for ways to lighten the pain. But the reality was, especially early on, that it was agonising to realise he’d wake up each morning and not know where he was. The first night R spent on the locked unit of a nursing home, he woke in the morning to the sounds of late-stage Alzheimer’s patients calling out repetitively, moaning, yelling inarticulately. These distressing cries rose above other noises – doors slamming, a floor polisher roaring, phones ringing, the staff’s conversation. “What’s that? Who’s that?” he demanded, over and over, starting at each sound. I could explain, but I wouldn’t always be there to remind him.

Ultimately, I think, he did come to some kind of terms with it. It became more or less a natural state, and if he couldn’t always recall exactly what had happened, he seemed to know that the nursing homes were where he lived and the others around him lived or worked there. He certainly was able to recognise and know different staff members and patients, so daily familiarity overrode the memory loss.

As for friends visiting, it is a difficult and uncomfortable reality. Even I, separated from long-time friends not by injury but distance, find myself feeling forgotten. I know people mean to email, but it’s easy to put it off until a more convenient time, which never arrives. I do the same thing. Immediately following R’s injury, many of his friends visited. But his confusion, restlessness and unexpected combativeness were hard for people to accept. I suspect also it was too upsetting to see this once athletic, articulate and intelligent man now confused and vague, sundered by aphasia and surrounded by others with dementia, many of them much older than he was and very infirm. One of his oldest, dearest friends told me that on his visit, R’s confusion was so extreme that, this friend said, “I wrote him off.” He never visited again.

People do that. They can’t cope with the change, they can’t see the person who remains, they can’t process the reflection of their own frailties, the reminders of our last end.

Brooke, that you and Peggy approach the future with hope, embracing the joys of your companionship, makes complete sense to me. R’s dementia was painful to witness; I hated that he was incapacitated. But he never – not once – suggested to me he did not want to live. For all the ugliness and mess of it, there remained some beauty and grace in his life. I am extremely glad that he lived rather than died after his injury. Your friends rejoice that you continue to live. You’re being strong for all of us.

Rainie and Norm at Peach Lake said...

Dear Brooke, The fact that you and Peggy "can still imagine something beautiful emerging from it" (- your situation)is exactly what I meant when I said that if anyone can survive this, it's you and Peggy! There is no other way than to follow the positive road, just as you are doing. Remember that each time we read about progress that you have made, even if small, there are more than a hundred of us out here cheering you on and feeling a great sense of elation. Keep working on that mind-body connection, keep the narrative going (it's important), and remember that you are a great inspiration to us all. Love, Rain

Talita from the Anna and Rose Team said...

Dear Brooke,

I am so glad that I found your blog. I was very worried about you and what happened. I was on a walk in the Canyon, the day of the accident, with a good friend, the man who gave you mouth to mouth. I am the one who helped the flight nurse turn you over and I searched your clothes for your ID.

I had no idea who you were at the time of the accident, simply did not recognize you. You know why that is so strange? Because Spring 2007, I taught right after you in the same class room and we always talked. I was in a different department but of course I had seen you many times in the hall, and after we were "class room buddies" we always talked for a few minutes in between our classes.

None of us knew how serious your injuries were but you did not look good. I saw the accident on the news that night but since they failed to identify the victim, I still did not know who you were. Then, a few weeks later I saw a report on the internet and realized it was you, Brooke. I am so sorry you are hurt but delighted beyond words that you made it.

I just found your blog and I finally have a way to contact you. If you would like a visit or any more details or info, please let me know!

Here is my email or you can call me 801.380.2100.

I hope you will continue to be in good spirits. YOu are an amazing person!!!
Love, Talita, your former class room buddy

P.S. BTW, happy belated birthday, just saw the blog entry, hope that you felt much loved on your special day!

Steve Adams said...

Dear Brooke and Peggy -

I am just sitting down at my computer to purchase airline tickets to come see you with Nick in a couple of weeks.

I was very moved by your account of sweating through the early part of your hospitalization. None of us has had such a terrible experience, so we can compare it only to our memories of lesser traumas. I can remember friends visiting me when I was hospitalized for depression and telling me to 'buck up'. I resented that! Later I realized they were encouraging me but couldn't understand why I was so incapable of pulling myself together.

I confess I am nervous how I will react when I see you, whether I will be inept and insensitive. Most people are uneasy about seeing friends who are seriously hurt. (I was always disappointed that very few of my father's friends came to see him when he had Parkinson's.)

I am so glad you still have such a sanguine view of life; that can come only through suffering and great courage. I am looking forward so much to seeing you again with Nick. You are still 100% Brooke and nobody else.

Love, Steve Adams

kjirsten said...

Hi Brooke,
It is wonderful to learn that you are recovering. John Erickson informed us that you had a terrible accident. I spoke with Joel Hancock and he gave us your blog. Kjirsten and I fondly remember the night you drove all the way from the Avenues to American Fork to have dinner with two poor college students. You shared your beautiful smile, passion for life, loving eyes, and ideas. How many students have had the gift of having a professor like you in their home. What an act of kindness! We still talk about that simple, enjoyable evening. Thank you. We are grateful you are well. Are you able to swim? Will you visit Torre this summer? As for us, we live in a suburb of Dallas Texas. Liam, 10, loves to swim competitively. He purchased a steer to show in the Beltbuckle Bonanza and County Fair. Caleb,5, enjoys soccor, art, friends, and school. Luke 3 - full of mischief and laughter. Claire, 9 months, has the most beautiful blue eyes and a smile that cheers our hearts. Kjirsten keeps us thinking, balanced, organized, fed, clothed, and loved. Our thoughts and prayers are with you. With Love - Quinn Grant and family