The two nurses answered my bell to take me to the bathroom. It was past midnight. They strapped me into a special jacket. Then, with a portable crane, they lifted me like a sack of potatoes into my wheelchair. They put my shoes on my feet. Except for the special jacket, I was bare naked.
I knew the girls had it all wrong. To begin with, I was supposed to be in at least a hospital gown and shoes. More seriously, I was supposed to be seated, not in my wheelchair but in a commode, a kind of elevated chair on wheels that fits over a toilet seat and has a convenient hole in the middle through which excrement and urine are designed to fall. They had at least gotten the shoes right. It was a safety policy for patients always to wear shoes on a linoleum floor.
I had known the hospital procedures for almost a week, and there was something infectious about the humour with which these nurses tried to get everything right but managed to get things mostly wrong. It was late at night, they were inundated with patients, I was a heavy-lift case and a commode case at that—the three of us couldn’t stop laughing. Finally, the two women got it right. They transferred me again with the heavy lift to the commode and covered my nakedness with a hospital gown and wheeled me to the toilet. The two nurses and I were giggling so hard I was afraid we’d wake up Homer, my roommate. One of them summed it all up: “What happens in Las Vegas stays in Las Vegas.”
I suffered an aortic dissection at my home on Good Friday, April 6, 2012. I had known something was wrong; I called Roberta Stavely, my Pilates partner, and Jan Carew, another good friend, and left messages on their answering machines. I told each I thought I was having either a heart attack or a panic attack and asked them to call me. I had been a widower for six years and lived alone, though my family doctor and good friend Dr. Liliane Bartha had recently moved in as my temporary houseguest. She found me late that night lying on the sofa in the living room, looking green. She immediately called 911. The ambulance came, but I insisted on retrieving my wallet and climbed the 11 stairs back to my bedroom. The EMTs protested that a man who could climb 11 stairs clearly wasn’t having a heart attack. But Dr. Bartha insisted. She recounts that leaving the house I rolled my eyes and said, “More drama.”
I remember nothing of that evening. My memory even of the several weeks preceding it only slowly came back. I apparently made a further telephone call to Jan’s answering machine, also lost down the memory hole, from inside the ambulance.
I underwent a nine-hour operation at the Foothills, during which I suffered a stroke. An aortic dissection occurs when the aorta splits open of its own accord. Surgeons commonly call it the widowmaker. It is usually unsurvivable.
This patient survived. I was in the ICU and a step-down ICU for about a month. I recall hearing voices, including my brother’s and that of Linda Johnson, who had power of attorney, and I dreamt vividly. I dreamt I was sailing the seven seas, in various vessels and various periods—always in sick bay. But I had to wait until I’d recovered enough to be transferred to a regular hospital bed to realize that I had become blind. When I learned this, I attempted to get out of bed. I hadn’t planned on being paralyzed in my right arm and leg. This was the only time I ever fell out of bed to the floor.
I was transferred to the Fanning Centre on May 22, 2012, with Margaret (my then-future wife) accompanying me in the ambulance. The Fanning, not strictly a hospital, is one of Alberta’s only two stroke rehabilitation centres. Built 40 years ago, it now runs, as does all of Alberta’s health infrastructure, at full capacity. Once admitted to the Fanning, I was thoroughly assessed.
Disabilities (deficits): paralysis in the right leg and arm; blind in both eyes; speech heavily impaired. The first six months is a critical period in the recovery of motor function in stroke patients. There was no time to waste. I was quickly immersed in the routine of stroke rehabilitation. I called it “my summer of rehab.” I had a daily occupational-therapy session followed by a speech-therapy session followed by a physical-therapy session. Margaret accompanied me during most of these speech- and physical-therapy sessions. On Tuesdays and Thursdays I participated in group speech-therapy sessions, and in time the physical-therapy sessions were followed by daily strength-building sessions. The sheer number of therapies tended to fill the days. But the weekends were endless. And the Calgary summer meant that I had to suffer through no fewer than three long weekends.
In the dining room, patients were assigned to tables, and since we met for breakfast, lunch and dinner, this made for comradeship. I was fortunate in my companions. There was Bob, whose major problem after the stroke was keeping his balance; he had made progress and was looking forward to being discharged. He was a naturalist, and his erudition, and what’s more his gentlemanly manners, made him a favourite among the ladies. What most interested me was his closeness to the Calgarian Tibetan community. My late wife had been a Buddhist; I had spent seven months in Cambodia and had written a novel set there with Buddhism as one of its themes. Bob and I had several long after-dinner discussions about Buddhist philosophy. Another favourite was Elsie. She was a high-performing stroke victim despite her great age. She was 97. Born in Philadelphia during the First World War, she had moved with her parents to Toronto but retained her Philadelphia accent. Hearing her was like listening to an historical gramophone recording. Her voice had also retained a typical American volume. You could hear her clearly across the dining room. I remember her saying with hilarious clarity, “Home was never like this!”
And there was Homer, my roommate. He was at the Fanning for months before my arrival, and still had no departure date when I left. We shared the same room for four and a half months, but not a word ever passed between us. It couldn’t. The stroke had robbed Homer of the power of speech. I was blind and he was mute and we were both lame. But that didn’t stop us laughing. We both had bladder issues. At night I preferred to wear a male adult diaper, and to call a nurse to wheel me into the bathroom. Homer elected to use what the Fanning called a urinal bottle. Unfortunately his aim was often off, and he would, not infrequently, leave the bottle lying in bed, where it would fall over. We had a nurse, an immigrant from South Sudan, a little woman with a very high-pitched voice. After every trip with me to the bathroom, she would inspect Homer. “Homer,” she would cry, “You’re wet!” and then, upon further investigation, even higher pitched, “You’re drenched!” There was something about her voice that moved Homer to laughter, even in his predicament; he was Jamaican and had a deep voice (his laughter was the only voice he had left) and I was moved to join in their hilarity.
The nursing staff was in every sense the backbone of the operation. I was lucky. On my very first morning I drew a nurse named Christina. When she entered my cubicle I was sitting on the edge of the bed, and that so impressed her that she proceeded to show me a technique whereby holding her across her shoulders with my good arm, I could dispense with the heavy-lift machinery and get directly into my wheelchair. Thus, on the very first morning, Christina broke Fanning Centre policy but gave me what was more important: hope. I remember also a young male nurse, Damian, who was always cracking jokes, sometimes at my expense. He always made me laugh.
Rarely would a nurse irritate me or make me angry. Although it did happen. I recall one nurse, a tall Jamaican woman, Sonia, who showed disrespect to an older lady and my dining partner. My grudge lasted almost a whole evening, until she was helping me in the bathroom—she was on night shift—and asked me in her soft Jamaican voice, “Dearest John, what’s the matter?” I recognized the term of endearment as standard Jamaican diction, but it melted my heart.
Of course, recent stroke patients are notoriously emotional. Tears ran down my face as I recited to my speech therapist “Jabberwocky,” by Lewis Carroll, and “The Second Coming,” by Yeats, a poem I had used in one of my books. And I remember also the tears of laughter when a nurse, I believe from Nigeria, told me, “You are blessed.”
“Why?” I had to say.
An aortic dissection occurs when the vessel splits open on its own accord. Surgeons call it the widowmaker. It is usually unsurvivable.
“Because,” she said, “as you know, the Fanning Centre turns off the boilers for the hot water at night to save money. And when, as I occasionally must, I have to wash a gentleman’s privates with freezing cold water, they almost always swear at me. But you only laugh.”
I should add that Sonia and I formed a bond of another sort. We watched together, or rather I heard and she and Homer watched on his TV, the US Democratic National Convention. If Sonia had been American, she would have been a Democrat. It turned out that she was intensely interested in US politics. “So much more interesting than Canadian,” she said. I couldn’t help but agree.
Of course, not everything at the Fanning was perfect. The food, although nutritious and sustaining and edible, was on the whole tasteless. The ladies at the table and I would discuss whether a soup was tomato or yam or carrot. We rarely came to agreement.
Personal hygiene standards were stuck in the late 19th century. Staff and equipment shortages ensured that showers were limited to one per week, unless a hospital visit was scheduled for that week. Fanning Centre patients couldn’t be seen by other physicians to be unwashed, unbathed or smelly.
More seriously, the Fanning Centre had little pull or influence with local hospitals or doctors. I was told in May that I would have to wait until October to see an ophthalmologist. Fortunately, friends, as they often did, came to the rescue—in this case Cheryl Cohen, who knew an ophthalmologist personally. He made room for me in his schedule in less than a month. Another friend, a Ukrainian doctor who had worked in a rehab hospital in Kiev, performed functional electrical stimulation (FES) on my right arm and hand for up to two hours a day in her time off. The half-hour-a-day AHS-supplied occupational therapy sessions were simply not up to that. It took the occupational therapist 20 minutes to set up her FES apparatus, which was very old, leaving 10 minutes for actual therapy.
The more technically educated the staff, the more effective they were. The nursing staff, the pharmacy techs, the therapists—physical, occupational, speech, even recreational—were all exemplary. The social workers were less so. It took one social worker from May until October to complete my application for Assured Income for the Severely Handicapped (AISH), despite my very effective advocate offering him every assistance.
The continuing education of staff occasionally took a hilarious turn. On one occasion I was enlisted to help describe to two young female nurses the correct operation of urine-collection trays for male patients. I pointed out that the tray’s orientation was critical. If the tray were placed upside down, the man’s scrotum would interfere with and possibly even contaminate the urine sample. On the other hand, the correct positioning would allow the man’s scrotum to hang free.
Sex, at the Fanning Centre, was a forbidden topic. When I mentioned to my young occupational therapist that when I kissed my fiancée, my hand spontaneously opened (my paralyzed right hand was usually clenched), her only response was “too much information.” I had expected she would find this professionally interesting. In the same vein, I was asked by the young speech therapist in a group session to create a sentence using the word “regret.” I said, “I don’t have many regrets, but I do regret lost opportunities for sexual intercourse,” to the uproarious delight of the group’s men. She dismissed us with, “That ends today’s session!”
In the end I stayed in the Fanning Centre for four and a half months. I successfully graduated on October 5, 2012, and remarried on October 6. I had known Margaret for two years, and although my social worker sought to delay the union, I overruled him.
Sonia gave me some sage advice the night before I left. Sharon, my lead physical therapist, bade me farewell in the morning. And before I got up, Chelsea, an assistant physical therapist, decorated my wheelchair with pink ribbons, a sign saying “Just About Married” and a few empty tin cans. I was wheeled out trailing them behind.
What did I learn at the Fanning Centre? I learned to dress myself, even though one-handed and blind. I learned to wash and take care of myself. I learned to walk with a cane and to take my first experimental steps walking unaided. I learned to live with my deficits—read disabilities. But most of all I learned compassion. Compassion for my fellow patients, but also for the staff who worked tirelessly day in and day out. In the words of Christina Rossetti, “To cheer one on the tedious way/ To fetch one if one goes astray/ To lift one if one totters down/ To strengthen whilst one stands.”
John Lathrop is a Calgary-based author. Now blind and one-handed, he uses a Dictaphone and Margaret, his wife, transcribes.