Stroke

by Ricky Monahan Brown

  ‘This just in,’ Paul tweeted. ‘Ricky’s loaf! (See you around 10.30, Beth.)’

  My nurses were rather less excited. After the loaf had arrived, Maria eyed my table suspiciously.

  ‘You’re not allowed to have that,’ she said, confiscating the butter knife and its six-year-old-appropriate serrations.

  ‘But . . . it’s not mine. It’s a friend’s. He made me the loaf. I can’t let you have his knife!’ Notwithstanding my apoplexy and my lack of inhibitions, I was too shocked and institutionalised to complain properly.

  ‘I’ll give it back to Beth when she comes.’

  ‘Is it a safety issue? What do you think I’m going to do with it? Hijack the hospital? I don’t even know where the cockpit is!’

  My pleas fell on deaf ears. Later in the day, Beth got the knife back and returned it to me.

  ‘Be discreet with it,’ she whispered, so when not in use the knife was tucked away in the folds of the dishtowel.

  As was only right, my safety was the paramount concern of the hospital staff. One weekend in the aftermath of Hurricane Sandy, the kitchen was closed, and the nurses relayed our lunch orders to the amusingly named deli down the road. Divine! With an exclamation mark! Excited to get some proper food from the outside, I ordered the veggie burger. It was Average! At best! Still, it was better than the grilled cheese sandwich, which was Decidedly Ropey!

  Worse was to come. Each evening, when Beth and I meticulously checked and ticked my next day’s meal plan, we were looking for stuff I would eagerly gobble, especially protein. Each day, more slop arrived. My only salvation was breakfast, consisting of a single-serve box of Special K, a thick slice of Ricky’s Loaf, slathered with jam and salty butter, and a cup of hot, posh tea.

  ‘Posh tea,’ I tweeted. ‘Thanks, Beth! Also, suck it, plebs!’

  Impulse control was still an issue, though not all the time. Every evening when we weren’t ordering from the deli, I would take my little pencil and cross out the qualifier ‘soft’ on all my menu options, and circle the word, ‘sautéed’.

  I remarked to Beth, ‘It seems less confrontational than scrawling “I didn’t break my jaw!!!” on the menu in my own blood. Also, three exclamation marks would be half an armful.’

  It was a shame that my pleas were to no effect. When their food wasn’t watered down and pureed, the kitchen at HJD did some great work. One day in mid-November, for example, I was served thyme-roasted zucchini sticks. They smelled dubious, but I was delighted to find they tasted of zucchini. Thyme, too! So I pleaded some more with my nurses and doctors to let me eat at the grown-ups’ table.

  When Liat arrived in the morning to chat rugby and other matters over word games, I related my woes. ‘What they told me is, the kitchen’s records have been left in disarray by the hurricane. Since we’re all presumptive choke risks, they’re having to be conservative, and everyone on the floor is getting soft food. Speech therapy has to approve my request.’

  ‘Your vocabulary’s not really been affected, has it?’ Liat remarked.

  Each morning, Liat wold assure me that the kitchen had been informed of my chewing and swallowing skills. Each day, nothing would change.

  Nevertheless, other improvements in my condition were becoming evident. My reckless impulses were being curtailed by occupational therapy. It seemed Sonoko was still concerned about grease fires, and every few days, I was asked again how I would handle one. I wondered if this had anything to do with the adventurous attitude Americans display around cooking oil. Every Thanksgiving, apocalyptic videos of turkeys deep frying flood the Internet. Burning barrels of bubbling, boiling oil. Trees being exfoliated as fat leaps into the air. Children running, their anguished faces framed by fire. Burning oil clinging to homes like sticky napalm.

  Then I thought again, and decided this had everything to do with my Scottish accent. We Scots will deep-fry anything. Twenty-three years had passed since the first time I ate deep-fried pizza from a chippy, and twenty-three years later, I could still taste the three-day old chip fat the pizza had absorbed until it was bloated to a multiple of its regular size. Maybe this was why I had resisted the temptation of the deep-fried Mars Bar for so long.

  Beth tells me I have to be careful with the terminology here. So, for our American friends:

  • Your Mars Bars are our Topics.

  • Your 3 Musketeers are our Milky Ways.

  • Your Milky Ways are our Mars Bars, which are yummy when battered, deep-fried and sprinkled with powdered sugar.

  • Don’t get me started on renaming Marathons as Snickers. I’m still furious.

  The unusual abstemiousness I had displayed in avoiding the deep-fried Mars Bar could have been ascribed to their being for tourists. Something an Edinburgh Festival-time visitor would breathlessly inhale as his nylon-clad arms, akimbo but zwip-zwipping against the fluorescent plumage of his torso, attempted to propel him along Edinburgh’s Royal Mile. There was no need for shame in Park Slope, however, where The Chip Shop on Fifth Avenue marketed the deep-fried Mars Bar as ironic exoticism.

  Although Sonoko would narrow a nostril and purse a lip at me attempting to operate a deep-fat fryer, a barbecue was an American Dream to which I was allowed to aspire.

  ‘Today, I want you to plan a barbecue for friends,’ she told me at my next occupational therapy session. ‘Where are you going to host it?’

  ‘How many people are you going to invite?’

  ‘What are you going to make?’

  ‘What will you need to buy?’

  ‘What’s everyone going to drink?’

  ‘What about dessert?’

  As usual, I partially flunked my occupational therapy test. I thought I could fashion a pretty good meal out of non-animal produce. Garlic bread. Corn. Aubergines. OK, ‘eggplant’. Yes, eggplant parmesan. Some veggie hot dogs. We would need buns and mustard and ketchup. This plan and its apparent contempt for my guests was batted away as yet another symptom of my inflexibility, so I offered up some halibut or salmon to assuage any blood lust on the part of the imagined mob. This latest sign of progress was enough for me to be awarded with an attempt at cooking for real. For the next day, I had to pick out something cheap and easy to make in a microwave. Sonoko would get hold of the ingredients, and I would make it the day after that.

  ‘If you want to eat well in England,’ W. Somerset Maugham once opined, ‘you should have breakfast three times a day.’ I decided to knock up some scrambled eggs. Two days later, Sonoko came to Room 920 and escorted me to the patients’ kitchen. Unlike the cramped scullery of any apartment I had lived in in New York City, it was a capacious cookhouse, with room to whirl a wheelchair, never mind swing a cat.

  Across the plains of the work surface, Sonoko arranged the supplies I had requested expansively, but within reach. A watery winter sun poured through the windows that ran along the wall of the canteen, and splashed across the eggs, butter, salt and pepper, and milk. A fork and a knife of appropriate bluntness sat in readiness next to a small Pyrex jug.

  Sonoko and I had discussed the steps I would take to conjure a fluffy scramble on our way to this orderly mess room. Now practiced in the use of a walker in my physical therapy, I propped myself against the counter and begin to methodically follow those steps, outlining each step as I was about to embark upon it. Sonoko offered little bits of guidance, or asked questions to prompt adjustments, as if I was her grandmother and she was teaching me how to suck the eggs. This was good, because beginning to take small steps, like preparing a simple meal, was nerve-wracking even though it was a process I had completed countless times before.

  Beth had a theory similar to Maugham’s: if you want to have a man make a good meal, have him prepare breakfast. After our first night together, I had slipped quietly out of bed, leaving her to sleep, and parachuted down to the coffee shop on the corner. I brought back two coffees, one latte and one flat black, neither sugared, both accompanied by various types of sweetener. This modular presentation, convertible int
o any one of a number of hot libations, was intended as an indication of capability. Of mindfulness. Innumerable weekend breakfasts would follow, during which I would learn how to accommodate our different tastes in eggs – her, either finely scrambled or fried with the yolk broken, always well done; me, over easy or comprised of thick and soft, lightly turned curds.

  Production of this meal was a guided meditation, Sonoko’s instructions returning my focus to the immediate action whenever my mind strayed or ran ahead. Still, hobbling from thought to thought and trying not to slip between the gaps, my mind dilated time. The yolk of the first egg slithered into the jug, and I thought of Beth’s dislike of a soft yolk. I thought of Paul and his wife, Jen, and their small family farm in Pennsylvania. I thought of what they had told me about the benefits of a poultry saddle.

  A poultry saddle looks just like its equine equivalent, and I love the idea of a little Beatrix Potter anthropomorph zig-zagging among the apple trees on a speeding hen. However, the function of a poultry saddle is to protect the hen from feather-scalping, rooster spurs and even death, at the hands of a very large cockerel. An industrial farm is unlikely to fund poultry saddles, even for a useful piece of capital like a brood hen, so the hens are kept in single-sex facilities.

  Beep. Beep. Beep. Beep. Beep. Beep.

  The microwave brought my attention back to the task at hand. I pressed the button and the microwave door popped open. My damaged dominant hand shook as I slowly, ever so slowly, removed the steaming jug from the thick glass turntable. I held the jug handle in that hand, so my previously neglected, impotent right could fluff the mixture.

  The eggs came out well. A sprinkling of grated cheese added a pleasing texture. I was discovering that little things were to be enjoyed more than ever. I was still alive after almost being not alive.

  What did that mean, though? Since the time of the ancient Greeks, we’ve had a terrible time expressing exactly what differentiates life from what is not alive. Soon enough, this stroke patient would read Ferris Jabr write in Scientific American of how the standard biology textbooks that define life have been reduced to replicating shopping lists of distinguishing characteristics. There are always exceptions, however. Crystals are highly organised and grow. Fire consumes energy and gets bigger. Some crustaceans can enter long periods of dormancy during which they are not growing, metabolising or changing at all. And on and on.

  In planning the ongoing search for life, an advisory panel to NASA came up with what they hoped was a lucid, concise and comprehensive definition of life: a self-sustaining system capable of Darwinian evolution. This doesn’t work either. According to this definition, a parasitic worm living inside a person’s intestines isn’t alive. Certain modern computer programs and platforms, on the other hand, do evolve and mutate within a self-contained context. RNA enzymes – or ribozymes – also satisfy the test. A member of the NASA advisory panel suggested that ribozymes mean we have to add another element to the test: to be alive, an organism needs to be inventive, needs to come up with new solutions. Already, we’re heading back to the textbook shopping list.

  Jabr concluded that the reason we can’t come up with a specific set of physical properties that clearly separates the living from the inanimate was because no such thing exists. To put it another way, there’s no such thing as ‘life’. It isn’t a thing. It’s an adjective. It describes a level of complexity. A level of complexity such that its shutdown will make us cry. An operation of zeroes and ones sufficient to make the gods weep thunderstorms of pathetic fallacy.

  As I lay in bed that afternoon, the sun shone through the window of Room 920 and I generated a cosy warmth under the hospital-cornered bedclothes. It was the warmth of the atoms within the egg molecules being reorganised and releasing energy. Twenty per cent of that energy would be used for brain metabolism. My complex machine still worked, in a fashion, after its power indicator had flickered off. Its operations were still a bit unpredictable, sure, but maybe that could be fixed. I needed to decide to be alive – to be inventive, come up with new solutions.

  I tapped at the iPad. The list of things I would have to do when I resumed Life was growing.

  ‘Consider veganism,’ I wrote.

  I opened another note, and wrote to the slim vegan with the toned musculature who didn’t exist. Yet.

  ‘I must never accept defeat. I must succeed. I must come back stronger.’

  There is no such thing as life, yet it can blink out in an instant.

  13

  Quiet: Patients are Healing

  Now my memory works in a way that approximates that of a real boy, I pretend to myself that I can remember more detail of the autumn of my stroke than I really can. It was a momentous time – for better or worse, nothing would be the same again.

  I do, however, retain a sensation of the terror that the nights would bring when the nurses would withdraw to chatter at their stations and the only figures by my bed were the vivid regrets of years past and the dark, long-fingered threats of the future reaching back into the present. That’s why, one night in early November after I had begun to show the first guttering flickers of rational thought and Beth had returned my phone, I tried in my mind to reconstruct the reassuring little apartment we shared.

  It was impossibly ambitious. I couldn’t remember what the apartment looked like at all. Once again, I recalled a detail of the bathroom and tried to rebuild from there, conjuring a dinosaur from a thigh-bone. It was futile. I just knew I wanted to go home. So I reached for the phone, my only anchor to a world where I had felt healthier and could hold on to a coherent thought. For once, it was in easy reach where I tried to keep it, under my pillows, not hidden in acres of rolling, hospital-cornered linens or a million miles away on top of the dizzyingly high bedside cabinet.

  ‘Can I come home?’ I pleaded, my despair flooding the line and pouring out through the earpiece into our 15th Street apartment.

  There was nothing Beth wanted more for me, or her. But someone had to be the grown-up. Although my pleas were tearing her up, my anguish was corralled by the power of her reassuring voice. Mature and complex, flecked with the dark deposits of a life well-lived, her voice had been smoothed by youthful experience earned through serious thoughts about how to live that life.

  ‘It’s late, honey. You have to get your rest. I’ll take you home soon, I promise. You’ll see me first thing in the morning.’

  Nights were a challenge. I was the kid threatened by the noises of the night-time house. Every cooling creak was an intimation of unknown terror. Every settling sound, a signal of a monstrous uncurling limb. Except, the threats here seemed more real. The hard railing of the bed pushed incessantly against my unfeeling arm. The vague sensation of discomfort was worse than pain. Was that muffled feeling the agony of gagged nerves screaming?

  The corridors outside the ward bore a command in red, hexagonal injunction: QUIET. Patients are healing.

  The bawling capital letters couldn’t be heard over the endless activity of the hospital, however. When I tried to recoup lost sleep, after Tenko’s morning ablutions and between therapy sessions, my day was broken up like a plane journey interrupted by drinks, meals, announcements, duty free carts. The passengers couldn’t be allowed to become listless. Breakfast. Doctors’ rounds. The long needle delivering abdominal injections of the Heparin that protected me from the blood clot that could finish me off. Lunch. Alfonso’s hollering television shows. Dinner. And, less structured but more structural, the on-going renovations of HJD.

  ‘Either someone’s got a hell of a lot of pressure on their brain,’ I thought, ‘or they need to calm down with the fucking incessant drilling upstairs.’

  At apparently random intervals throughout the day, jackhammers would pound in mocking derision of the six-sided sign that demanded quiet. Then eventually, our lights would be dimmed.

  Nights weren’t always better. In addition to the regular moans of my fellow patients and my own night-time fears, on the night of 15th No
vember, Alfonso’s family descended en masse. For someone so particular about his sleeping arrangements, The Wee Man and his family were remarkably blasé about anyone else’s ability to get some kip. I fumed silently, not wishing to poison Room 920’s well, or spur the Dallier clan on to further heights of raucous rage against the dying of the light. I muted my complaints, not least, because of my eternal gratitude to The Wee Man for handling my first day fall so well.

  The next morning, the cause for all the hubbub was revealed. During a merciful lull in the infirmary’s attentions, Alfonso approached my bed.

  ‘I am leaving this morning,’ he told me. ‘Goodbye. And good luck. To you and your wife.’

  His farewell was fond and tender, and I basked in it. It wasn’t a time for technical quibbles about marital status. I was getting to see another side of my room-mate.

  ‘Thank you, Alfonso,’ I said. ‘I hope everything goes well. For you and your family. That’s a nice bunch of kids you have. You must be very proud. Wish them all the best for me.’

  Alfonso was being shipped out to a sub-acute facility. A place that fell somewhere between HJD and a nursing home. Sub-acute programmes cater primarily for patients who are in the initial stages of recovery and aren’t ready for the hard work of rehab, as well as those who have completed acute rehabilitation and are ready to step it down a notch.

  Arguably, The Wee Man shouldn’t have been under the care of the Rusk Institute in the first place. To be assigned to Rusk, a patient has to fall within a narrow slot of disability. They must be damaged enough to require intensive rehabilitation but have enough potential to benefit from three or more hours of rehabilitation a day, and have the ability to put in those hours. There had been much discussion of where I was on this spectrum before the ambulance had been assigned to take me out of Methodist Hospital.