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ralph robert moore
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Copyright © 2002 by Ralph Robert Moore. All rights reserved.
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june 1, 2002
That Sunday before, April 14, was, for Mary and me, a perfect day.
We spent it outside, in our garden.
It was the first time we had worked out there together in a while. The year before, Mary contracted a bad case of poison ivy in the garden, which still kept cropping up occasionally on her forearms. She went to different doctors, and finally a dermatologist, but all they could give her were salves to keep it in check, rather than eliminate it.
This day, though, she stayed away from anything remotely resembling a vine. We started the morning by going to our local Calloway's nursery, buying impatiens, geraniums and petunias. After we got those planted in different areas around our yard, we decided to put together two white PVC trellises we bought for one side of the house, near the chimney. We already had the morning glory seeds.
The trellises were extraordinarily difficult to assemble, both of us kneeling in the dirt, making faces as we tried to force the bars over to their different holes, but we didn't give up, something I learned from Mary. Occasionally, over the years, we'd have to assemble something, a ribbed chest, speakers, that, after an hour or two, would seem impossible to do. They must have left off some parts from the packing case, or the parts we had must be deformed. I would usually give up on the assembly-- I remember a huge pile of slats and screws we tried to put together once-- but then, an hour later, Mary would call me out to the garage, looking proud, to show me she had finally figured out how to do it, and we'd have a new CD rack.
So we stuck with the trellises, stopping from time to time to just sit in the dirt, resting, wiping our faces, talking about this and that, and finally we got both of them right, everything snapped in place, and put them against the brick wall.
By then it was getting into evening. We shook out some coals into the barbeque for the chicken we were going to grill for dinner, sat at the back of our property, under the trees, where it's shady and cool, having a couple of beers, looking around at everything we'd done over the years, listening to the birds, watching the butterflies, the way the wind, high up, moved through the tops of the trees. At one point Mary, happy to be gardening again, turned to me with tears in her eyes and said, "I had forgotten how much fun this is."
I've often thought that when I die, if I'm allowed to have only one moment from my long life flash before me, it will be one of these ordinary Sundays the two of us have spent out in our garden, working side by side, looking up occasionally, sweat rolling down our noses, to grin at each other.
The following Wednesday, April 17, Mary went into work around seven. I work from home now, but she still has to battle traffic each day to get to her job in north Dallas, where she's Manager of Human Resources and Administration for her company.
As we always do, I called her at ten-thirty that morning, and again at noon, so we could let each other know how our day was going. Mary was scheduled to have lunch with a couple of her girlfriends, Gayle and Susie. Gayle works for Mary. Susie used to, but left a couple of years ago for another job, though she stays in touch with Mary. I had been scheduled to have lunch with my friend Dave, but he cancelled (fortunately, as it turns out) earlier in the week.
Our noontime call was the way it always was. We joked around, talked about the upcoming weekend, the fajitas we were going to grill that evening. After telling each other "I love you", we hung up.
I went out to the kitchen to get a Slim Fast for lunch, drank it at our kitchen table, looking out at the backyard, then went inside our bedroom again, where my work office is, in a windowed alcove, to continue a project I had started.
The phone rang.
We have Caller ID, so I could see the name of Mary's company displayed. About fifteen minutes had passed since we had talked. I picked the phone up, saying Hi, calling her by the secret name we have for each other.
Except it wasn't Mary on the phone, it was Gayle.
"Rob, I don't want to alarm you, but Mary's been taken by ambulance to Medical City Dallas. We think she's had a stroke."
Mary and I have been married for twenty-one years, and have been living together for twenty-three years, stretching all the way back to the late seventies. All that time, we've lived only for each other. She's my whole life. I'm her whole life.
It took a second for Gayle's words to register. I don't remember what I said, but it was probably something like, "Is she all right?" I was stunned. If you love someone, and they love you, and you've been together for so many years, you know in the back of your mind someday something bad is going to happen to them-- we don't live forever-- but you always think of it happening sometime in the distant future.
Gayle told me she went into Mary's office to get her for lunch, asked her if she were ready, and Mary, sitting at her desk, just stared at her. Gayle repeated her question, walking closer, and saw Mary didn't seem able to speak (something closed inside me when she said that). "Her eyes were open, I think she saw it was me, but I could see in her eyes there was confusion about why she couldn't speak, and impatience with herself that she couldn't."
We only have one car. I was stranded about forty miles away from where Mary was, with no quick way to get there (the town we live in is so small there's no taxicabs.)
Joel, who works with Mary, he's Senior Vice President at the company, offered to drive to where we live to pick me up, to take me to the emergency room.
I hung up thinking, I've got old clothes on, I should change, I should gather up whatever money we have in the house, in case we need it, I should feed the cats again, in case we get back late, shut all the windows, do this, do that, while Gayle's words, "we think she's had a stroke," kept getting bigger and bigger in my mind, I kept picturing her sitting at her desk, not able to speak, not knowing why, and I just collapsed on my knees by the side of our bed, sobbing, begging that Mary's life be spared.
I stopped crying almost at once, telling myself I had to be strong for Mary. I got dressed, got whatever money we had in the house, fed the cats, shut all the windows, then waited, staring at the front door, for Joel to arrive, trying not to think too much, so I could keep myself together.
Gayle was inside the emergency room at the hospital. I went over to the front desk, let them know I was here, and they told me Mary was about to be transferred downstairs, for some additional tests. I hurried to where she was, to be able to go with her.
Mary is extremely bright, with a great sense of humor. When I reached the corridor where they were getting ready to put her on the elevator, she was lying on her back on a gurney, wearing a hospital gown, tubes going into her arms, wires taped to her chest. Her eyes were open, but just staring. I grabbed her hand, kissed her, her eyes seeming to track to me, held her hand as we all went down in the elevator. One of the technicians accompanying her gurney told me her entire right side was paralyzed, and she couldn't speak.
There wasn't enough room for me in the room where they were conducting the tests, so I waited outside. There was a courtesy phone in the hall. I called Joel on his cell phone (Joel and Gayle were still upstairs in the emergency room), to let them know what was happening. It dawned on me our car wasn't here, because Mary had taken it in that morning for its 75,000 mile check-up. They both immediately agreed to pick it up for me, and drive it to the hospital, so I'd have it when I needed it.
After the tests were finished, Mary was wheeled out again. I grabbed her hand, talking to her, but not getting any real response. I kept talking to her, trying to reassure her, to let her know I was here, while all of us went up in the elevator, then down corridor after corridor to the Critical Care Unit.
Once at the CCU, Mary was lifted off the gurney and put in a hospital bed. The nurse told me the neurologist at the emergency room who had first examined her was going to study her test results. He'd stop by the CCU later on in the day, at which point I could talk to him.
At the CCU, each room is a small square alcove with the front side completely open. Mary's CCU nurse, who I was introduced to in the confusion of everything, sat right outside the alcove. I pulled a chair up to the side rail on Mary's bed, holding her hand again while she stared up at the ceiling. At one point, one of the nurses came by and gave me a beeper, showing me how it worked. If I was in the restroom, or out in the corridor, and they needed me to come right back, the beeper would sound.
Joel and Gayle came back, handing me the keys to our car, which they had parked in the emergency room parking lot. We talked distractedly for a while, then the neurologist showed up. He took a look at Mary first, trying to talk to her, not getting any response. He tried to get her to squeeze two of his fingers. She didn't. He started telling me about her present state, but I motioned for him to go out into the hallway. I didn't want Mary to hear anything bad.
Out in the hallway, he told me Mary had suffered a massive stroke. Her right side was completely paralyzed, and she wasn't responding to questions. "We gave her a shot of TPA, which is kind of a miracle drug for stroke victims, but it doesn't look like it took."
"How bad is she?"
"With a stroke of this intensity, the real danger is the extent of the brain swelling and hemorrhage that occurs afterwards. There's surgery we can do to get in there to try to stop the swelling, or the hemorrhage, but frankly, I wouldn't recommend it. It almost always fails."
I said nothing, just nodded.
"If the swelling reaches a critical point, or the hemorrhaging, to where it's critical, there's really nothing we can do. She had a very bad stroke. I hoped the TPA would work, but it doesn't appear it did."
I understood what he meant by 'critical'. "I appreciate you being honest." I turned away, started to choke up, but fought it down, suppressed it.
"The next four to five days, through the weekend, are the critical window. We'll have to see the extent of the swelling, or the hemorrhaging."
I asked how we would know if there was much brain swelling, or hemorrhaging.
"If she's difficult to rouse during that time, that would indicate the swelling or the hemorrhaging is passing over into a critical stage. There's little we can do at that point. I wish I could be here through these next four to five days, but I'm leaving tomorrow for a conference. I've arranged with some of the other doctors here at the hospital to look in on her while I'm gone. And I'll be back on Monday."
I spent the night in the CCU cubicle with Mary, holding her hand, resting the side of my head on the top of the metal side rail of her bed. I dozed once or twice for a few minutes, but that was it. (You're allowed to sleep in the CCU waiting room, and in fact they even pass out pillows and blankets if you choose to do so, but that seemed too far away from her, all the way past the double doors and halfway down the corridor.) I tried not to really think about what the neurologist had said. It wouldn't do any good to think about it now. The only thing that would help now would be prayer. So I prayed, to myself, over and over again, calling on God, calling on the dead. Occasionally, Mary would look over at me. She yawned a great deal, the kind of real mouth-stretching yawn, head rolling to one side, that I later found out was typical with stroke victims.
Around eight o'clock the next morning the new CCU nursing shift came on. I introduced myself to Mary's new nurse, and watched as she stood at the side of Mary's hospital bed, talking to her in a loud, clear voice, trying to get Mary to raise her left arm, raise her right arm.
She responded to the requests by raising her left arm, about a foot off the bed, but couldn't move her right arm at all. Or her right leg. Or wiggle her right fingers or toes.
But she seemed a little more alert to me. The nurse and her assistant remarked that as I moved around the bed to make room for them, Mary's head on her pillow, and her eyes, followed me around, to stay always fixed on me. I started to have some hope. (And I'll remember her swiveling eyes, staying always on me no matter where I moved around the bed rails, the rest of my life).
Around eleven o'clock that morning, Susie, Mary's girlfriend, showed up to relieve me. I drove home to feed the cats, about a forty minute drive, and to get some sleep. I didn't want to leave, but I knew I had to sleep, and eat, to stay strong for Mary. My car was in the emergency room parking lot. I started it up, drove around the lot to the barrier across the exit. It was down. There was a slot to put in your coded parking ticket, but of course I didn't have a ticket, since I hadn't parked the car. I stared stupidly at the barrier, trying to think what I should do. A hospital security truck came by. I lowered the driver's side window, letting in the rain, raising my voice to be heard, explaining the problem. He gave me a numerical code to enter, to get the barrier to raise.
Our home was empty without her. I saw all the hundreds of familiar things, even the dust and deserted cobwebs, and wondered if she'd ever see them again. I felt terribly alone. The one person I could talk to was now the one person who couldn't talk at all, or understand anything but the simplest phrase. I wanted to turn right around, after feeding the cats, to drive back to her, but forced myself to undress and get in bed. I pulled her pillow over, to lay my head on it, so I could smell her, and pulled the covers up to my head. I slept, finally, about an hour. Got back up, showered real fast, drank a Slim Fast, and drove back to the hospital.
Mary lifted her head when she saw me, and grunted. I grabbed her hand again, holding on, talking to her. She still had tubes in her arms, wires pasted to her chest, and a catheter up between her legs, dripping her urine down to a jar under the bed.
During the day, as different nurses came by to check on her, it seemed to me she was getting more and more responsive. At one point, around eleven that night, she smiled at me. I forced myself not to cry, because I knew she would be looking to me for any signal as to how she was doing, and if I cried, or looked upset, that would distress her. So I smiled back, beamed, in fact, because I really was so happy to see that smile, squeezed her left hand, and she squeezed back a little.
I went home after that. I e-mailed my employer, a brief note, to let them know what had happened, and that I would need an emergency leave. I tried eating, a frozen chicken dinner we had out in the freezer in the garage, but I couldn't get more than a bite down, it tasted disgusting, so I threw it out. I slept a few hours this time, woke up about four, showered, called the CCU nurse to see how Mary was doing. The nurse said she seemed fine.
I tried calling her dad. Every other Friday we talk to Joe on the phone after work, for about an hour. I knew it would alarm him if we didn't call later today, since this was the day of our normal Friday call. I kept getting his answering machine, though. I didn't want to leave a message, because telling him his daughter had a stroke and is in the critical care unit isn't a message you leave on an answering machine.
Later, at the hospital, going downstairs for a break, walking around a fountain in a plaza in the center of the huge hospital complex, I was able to get through to him on our cell phone. I started off by telling him Mary was doing better, but that she was in the hospital, and had suffered a stroke. He agreed to fly down that Sunday, two days from now. I wanted Mary to be able to see him, to know that everyone she loved was right there for her, rooting for her.
That night, when I got ready to leave to go back home, I kissed her on her forehead (we kiss each other on our foreheads when we part, to protect the other while we're apart). With surprising strength, her left arm reached behind my neck. She pulled me down, kissed me on my forehead. Her eyes still seemed dazed, but it was obvious she knew what she had done.
That kiss on my forehead meant so much to me. My hope grew that someday she'd be out of this hospital, home again with me.
I stopped at a supermarket on the way home Friday night, buying a few items, getting money from the ATM, really just walking around in a daze, trying to get things done. Back home, I tried to eat again, but couldn't, so I threw that meal out too. I opened a beer, rooted through Mary's purse, which I had been handed the first day, along with a bag full of the clothes she had been wearing when she had a stroke, all of them black, and pulled out the bills. Sitting at our breakfast nook table around midnight, sipping my beer, I paid all the bills that were due, found some stamps, and made a list of what I should buy for Joe's visit. (Throughout this whole time, I would constantly remind myself of things I needed to do. For example, since I was driving late at night, and early in the morning, I had to use the car's headlights. I had a constant worry I'd forget to turn the headlights off when I got home, and the next morning the battery would be dead, meaning I'd have no car to drive back into the city to see Mary. Worries like that. At the same time, each day a different song would start playing in my head, and I could not get that song out of my thoughts all day. And it wouldn't even be a favorite song, just some B-side tune from the past, or a commercial. I figured my mind was doing it to keep me from thinking too much about brain-swelling, and hemorrhaging.)
Mary improved steadily during the day Saturday, and in fact even stood beside her bed a little. She started saying words, like "movies", even though the words themselves weren't appropriate. But they were real words. Late that Saturday night, we were watching a movie on the USA network (there was a small TV mounted on the left just under the ceiling at the front of her cubicle), when she started motioning at the TV. It was obvious she wanted me to do something. I pointed at the TV. Do you want the channel changed? Head shake. Do you want it louder? Head shake. Softer? Head shake. Do you want it off? Head shake. I was running out of questions. Do you want it tilted at a different angle? Head shake. Do you want the curtains at the front of the cubicle drawn farther to the side? Is that blocking your view? (but it didn't seem they could be-- they were already drawn away from the TV). Head shake. That went on for over an hour, Mary getting more and more frustrated, making sentences that were just nonsense syllables that I think she thought at that early point in her recovery were clear instructions, pointing her finger repeatedly at the TV, me getting more and more desperate to figure out what it was she wanted. Finally, and I don't honestly remember how we made this breakthrough, I realized what she wanted me to do was turn off the overhead light, so it wouldn't cast a reflection on the screen.
The next day, Sunday, April 21, Joel volunteered to pick Joe up at the airport, which I very much appreciated, because at this point I was exhausted, from that Wednesday to this Sunday I had lost about twenty pounds, and knew a trip all the way out to the airport and back would wipe me out. Mary said a few more words, and started smiling when she saw me, reaching out her left hand for me to hold it. A physical therapist came by to see if Mary could walk (she was able to move her right arm and leg again). She got her to stand up by the side of the bed, then wrapped a heavy canvas strap around her upper body, grasping the strap in back in case Mary started to fall. Together, the three of us shuffled down the corridor outside Mary's CCU cubicle, about fifty feet and then back. Mary was grinning, glad to be up, looking around at all the other cubicles, trying, I knew, to figure out where she was, and after that, why she was where she was.
Later, a speech therapist came by, trying to get Mary to pronounce different words. I could see Mary trying earnestly to understand what she was being asked to do-- to repeat back the words the therapist was saying-- but she couldn't make the connection. The therapist asked her what her name was. She couldn't say. She asked her to write her name, and, astoundingly, in small block letters, she did write out Mary. "Sometimes at this stage it's easier for them to write words, instead of say them."
Afterwards, when the therapist was gone, and Mary was trying with such careful, heart-rending enunciation to tell me something which I couldn't figure out, poor sweet face pushing forward, lips blowing out random syllables, I handed her the pad and pen. "Can you write it? Can you write what you want to say?"
She held the pen at an odd angle, much farther up the pen than she normally would, then very slowly wrote in small block letters.
I turned the pad around, looked at it.
She had written: very caution.
More next week.