In the old days, it was known as Charity Hospital. It was where you went if you were poor or without insurance. No one was turned away and, it was said, if you didn't die waiting to be seen, you had access to some of the best medical care in the state.
Now, it's known as Louisiana State University Medical Center, a sprawling complex of old and new buildings, a cancer care and research center, an ambulatory rehabilitation facility, trauma center. It's still some of the best care in the state and still where you go if you're poor or insurance-less. This is where the firemen took my friend Henry - kicking and screaming - after the 911 call, and where I spent most of yesterday and last evening. It was the 3rd of 4th in a series of mini-strokes, this one far more serious, resulting in paralysis of his left side, impaired vision and speech, and a general overall sense of confusion. A fast acting medical team wired him up to monitors and heart machines, placed electrodes on his chest and inserted iv's, scheduled an MRI. The doctors spoke of clots and cranial bleeds, even a possible tumor. I sat by his side and watched him struggle with the pain and the slurred speech, the inability to shift position, the helplessness. I was encouraged that he was still lucid, still able to make a joke despite his surroundings. His wife of some thirty five years wavered between hysteria and calm and ridiculously enough I was reminded of a tennis match - in one moment she smiled and told him not to worry, reassured him that the car hadn't been towed away and the animals were in good hands. In the next, she dissolved into helpless sobs and began wailing like a fishwife, begging him, for her sake, not to die. The scene went from horrific to comic to tragic to cartoonish and then began all over again.
Day Two
It's a game of watch and wait. The MRI has been tried again without success and is now scheduled for Monday - it will be accomplished with the aid of anaesthesia and can't be done earlier due to the holiday. There's little improvement or decline but there are some small signs of hope - he's resting a little more easily and has shown signs of some feeling in his left leg. His daughter, a voice of reason and maturity and level headedness, is here and just her presence makes a difference. She is calm,
quiet, with a remarkable mixture of compassion and objectivity, able to prioritize and ask intelligent questions. With her mother, she is firm but kind, brutally but gently honest, optimistic but not blinded, capable but not overbearing. Slowly and carefully but absolutely unswayed by tears, pleas for pity, anger or guilt, she leads her mother away from illusion and unrealistic expectations. She refuses to be drawn into the net of hysteria, will not engage in an argument, is clear that she will not neglect her own needs even during this. I watch and listen and am stunned by her maturity and ability to diffuse and redirect her mother's melt down. She looks for solutions, strategies, aftercare and reality while her mother looks for mercy and magic.
Day Three
There is talk of lifestyle changes to be made, a reassessment of responsibilities and caregiving, a major shifting of balance in who cares for who. Daughter lays out the most probably outcome, mother resists. She wants him home, she wants him the way he was, she wants this is to be a bad memory that she can push away and never think about again. She listens to talk of recovery through therapy and rehabilitation but her eyes glaze at the prospect of a lengthy separation. She has to be led one step at a time through the process - it has to pointed out that she will not be able to care for him at home, that she has to work, that therapy requires trained professionals, that he cannot be left alone in a house full of dogs and cats, that in the beginning he will likely not be able to walk, much less cook and clean and shop. His days of step'n'fetch it are over, daughter says clearly, with a bluntness that hurts my ears. Mother winces at this cruel truth, begins to sob against the bed rail and appeal to God. Daughter sighs but doesn't relent, telling her it's time to put on her big girl panties and face the music - her life is never going to be the same again and for everyone's sake, this is something she must accept. But the MRI, her mother protests, after that they can treat him and give him blood thinners or medication. They'll fix him! She grips my hand with surprising power, begging me to say she is right, unable to give up her hope. I meet her panicky eyes and slowly shake my head, Medicine isn't going to bring him back, I tell her, Therapy and rehab are and it's likely to be a long process, weeks, maybe months. She glares at me then at her daughter, her face a ruined mask of tears and denial and outright terror. I can't do this! she wails and her daughter stands firm. You can and you will, she says clearly and adamantly, There isn't any other choice.
The man sleeping restlessly in the hospital bed, tosses and turns, mumbles incoherently, jerks his muscles and with his one good hand massages his jaw and paws at the IV on the back of his hand.
Everything fall quiets. We are weary of this stroke watch, him most of all.
Day Four
The doctors say it's time to exercise his swallowing reflex - as many sips of water as he will take,
some clear broth, some tasteless mash potatoes. His wife tries this and he resists, she instantly falls to pieces and begins to cry. I try the water and get him to take about a half cup over the next few hours. He is clearer, more aware of where he is and why, and he sleeps. She is overwhelmed and distraught, not able to think clearly, not sure what to do - her body, aging and overweight with back and knee problems and now in constant pain, is betraying her, all these responsibilities and things that must be done are more than she can organize or bear.
The doctors arrive with news that they have located someone who can deliver anaesthesia and they have scheduled the long awaited MRI for later that evening. This news brings a fresh wave of tears and she collapses on the small leather couch, shoulders heaving. I tell her to make me a list of what she needs from the grocery, warn her that I will beat her senseless if she doesn't eat and get some rest, and then prepare to return to my own life. Is there no one you can call to help out? I ask her quietly, and she shakes her head almost violently. We have no friends, she says. Her sadness and loneliness are mostly self inflicted, I remind myself, over the years her behavior has often bordered on mental illness and driven away anyone who might have wanted to care. Her dependence on him is total and all consuming - I've often thought of him as more a servant than a partner, emotionally battered to the point of helplessness and alcohol. Still, I can't bring myself to feel anything but pity for them both. It may be that we are never fully prepared to face our faults and make amends - her desperate struggle for control, her isolation and jealousy, her temper - all have come home to roost.
Her random madness, whether real or manufactured, has left her bitter and rejected, exhausted and frantic - there are no get well cards, no flowers, no called in well wishes. There have been no visitors to this small and sterile room with its one small window, no one has dropped in or brought books or magazines or milkshakes. And it's only the beginning of a very long road.
Day Five
The MRI has disclosed a blocked cranial artery and the relief of having an actual diagnosis and a plan of attack - surgery scheduled for two weeks out - has changed things drastically. There is cause for optimism and hope and a real chance at recovery. As I fed him apple sauce and mashed potatoes, I reminded him to chew and swallow with each bite and he nodded and followed instructions, washing it all down with a milkshake. His wife has come to terms with the issue of caregiving, understanding at last that he will not be coming home next week and making peace with the idea of a rehabilitation hospital for the immediate future.
I will keep in close touch, visit as often as I can, provide them with as much help and support as I can give but it's time I get back to my own life. It wasn't the Thanksgiving Week I had planned or hoped for yet oddly and ironically it brought me closer to a woman I have despised from a distance for years and gave me a new appreciation of what it means to be thankful.
Maybe there is a little magic to be found after all.
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