LEN BIAS: CROSSOVER
A novel
By: Michael D. McClellan | September 19, 2010
The exercises continue until 5PM. Alice tells me that I've done exceptionally well with this portion of the assessment, and urges me to get some rest. There is a full day planned for tomorrow. She leaves and I'm hit with a sense of déjà vu, as if we've shared time together before. By the time she returns in the morning I've forgotten all about it, my mind consumed with thoughts of my parents and a growing fear that I've gone off the deep end, losing all touch with reality and becoming increasingly unable to separate fact from fiction, real from imaginary, truth from lies.
~ ~ ~
Day 2 begins with another batch of Alice's mental exercises - word games, quizzes, puzzles, brainteasers. There are interruptions galore: Dr. Smithson stops by at one point, Dr. Abraham at another; nurses are in and out of my room all morning, checking vitals, changing IV bags, rotating my position in bed to prevent bedsores - pressure ulcers, one of them says as he shifts me around, sending an angry burst of pain through my leg. I try my best to stay calm and focused. Above all else I try to remain positive.
By early afternoon we move to the subject of memory. Alice asks Emily to leave at this point, and for the remaining two hours I'm asked about family, friends, childhood experiences, school, work, church, hobbies, interests, vacations, holidays, colleagues, casual acquaintances. I laugh at some of the stories I tell. I cry at others. I tell Alice how scared I am, how alone I feel. She reassures me that everything is going to be fine. She promises to help me through this situation, no matter how crazy or confusing or overwhelming it may appear to be now. Somehow that makes me feel better - not much, but better. In spite of the constant interruptions we wrap precisely at 5PM, at which point Emily is allowed back in the room. Alice congratulates me on a job well done. A follow-up consultation is scheduled for Friday, July 8th - three long days away.
Depression swoops in on me several hours later, as the weight of the questions and the flood of memories generated from them finally become too much to bear. I sob uncontrollably. Emily holds me, tries her best to take the pain away. She cries along with me. We talk for awhile, first in normal tones and then in hushed whispers, until we fall asleep hand-in-hand, the soothing sound of Bach playing softly on the CD player somewhere behind us.
~ ~ ~
Wednesday starts with a move from ICU to a private room, a milestone that gives me hope and lifts my spirits. My leg also feels much better, and for the first time since emerging from coma I don't need pain meds at any point during the day. Emily warns me that a private room means more visitors, and that my basketball team is planning a trip to Cleveland as soon as I'm ready for them. I'll also be allowed to watch TV and read magazines and newspapers beginning this weekend. Until then it's a steady diet of what Alice calls cognitive rehabilitation exercises - crossword puzzles, card games, math problems, Q&A sessions. It's all on Emily and me; she teaches me how to play Hearts and Rummy, and we wage an epic battle of War that lasts nearly three hours. Through it all I try not to think about who I am and what I've become, or how something like this happened in the first place. Instead I hope for the best and pray to God for my life back.
~ ~ ~
I throw myself into getting stronger, knowing the sooner I'm out of this bed the sooner I'll have control of my situation. Devon the physical therapist stops by twice each day to work on stretching and strengthening, and I'm ready for him when he arrives. He's a friendly guy, black like I once was, and talkative. We work through range-of-motion exercises and his mouth never stops: He tells me that he's from Georgia, that he moved up here because of a woman, and that she had recently left him for another man; he says that he hates the cold Cleveland winters; he promises me that the rehab work we're doing will pay big dividends, and that I'll be back on my feet in no time. I ask him questions about my broken leg and the metal rod, and he tells me that I've got my work cut out for me. Slow recovery, lots of rehab, a constant battle with swelling. The key, he says, is staying positive. There will be good days and bad, but the key is not to let the bad days bring me down mentally. I like what he has to say. It's sound advice, and whether he knows it or not, it applies to much, much more than my shattered right leg.
~ ~ ~
Emily shaves me on Friday morning after the nurses finish cleaning me up. I feel like a new man in more ways than one. The thought is loaded with irony and I can't keep myself from laughing out loud. She wants to know what's so funny. Private joke, I reply. Private joke.
~ ~ ~
Dr. Alice Reynolds enters the room at 2PM on Friday afternoon. She exchanges pleasantries, makes small talk and then pulls up a chair.
"Thank you for being so patient these past three days," she says. "We covered a lot of ground, and I needed time to fully prepare for this part of the assessment."
"Is there something wrong?" I ask. There is an urgency in my voice that's impossible to hide.
"You've made tremendous progress. Dr. Smithson and Dr. Ghajar both agree that you're far ahead of most patients in your situation. From a cognitive standpoint, you are functioning like someone who hasn't suffered brain trauma. It's really quite remarkable."
"Hon, that's great news," Emily says.
"Yes, it really is," Alice replies. She turns back me, our eyes lock. "In the vast majority of patients who have suffered injuries like yours, there is an extensive amount of cognitive rehabilitation that needs to occur. And that's because in almost all of these cases there is a significant level of brain damage."
The words hang there, pregnant. A nervous jitter hits my stomach. "I've always had a hard head. I guess this time it paid off."
"I wish it were that easy to explain. Dr. Smithson and Dr. Ghajar saw nothing on the initial CT scans to suggest extensive internal bleeding, which is extremely rare with this type of brain trauma. That means that the increased intracranial pressure was due to a rise in cerebrospinal fluid pressure. And that is a much more treatable situation."
Emily holds up her hand. "English, please."
"I'm sorry for being so technical. In Jason's case, there was only a very small amount of bleeding. Just enough to cause a buildup of the fluid that circulates in the brain."
"And that was the source of the pressure."
"Yes. The speed at which the doctors were able to get those pressures down is astounding, especially without drilling a hole to drain off the fluid. Less that one in a thousand cases turn out like your husband's."
"So you expect that Jason will make a full recovery?"
"I can't speak for Dr. Smithson or Dr. Ghajar, but from a cognitive standpoint I'm extremely encouraged. With these types of brain injuries, gross or large-scale systems usually need to be retrained. Things like attention, focus, and perceptual skills. Only then can we begin to focus on complex intellectual activity. Further evaluation will need to be done, but your husband appears to be perfectly fine on both fronts."
"Thank you God. Jason, did you hear that?"
