“Well, you’d be surprised. Many of the people we treat, they get down.”
“You mean depressed?”
He frowned. “Yeah, it’s a typical phase most go through. Expect it to happen, and if it doesn’t, it’s a giant plus.”
Vinny shifted in his seat and nodded.
“The treatment your brother will receive here is comprehensive.”
“Like physical therapy?”
“That’s just one component. We practice a holistic approach. He’ll also work with a speech pathologist, a neuropsychologist, an occupational therapist, a recreational therapist, and a social worker. There’ll even be someone for you to help you deal with all this.”
“I’m okay. I don’t need any help.”
Clalia relaxed in his chair. “Well, we find most families need help with things like how to modify the house to prevent falls, or recognizing the early signs that the patient may be engaging in risky behavior.”
Vinny pulled his chin in.
“Risky, like drinking alcohol or an activity that heightens the risk of a concussion.”
Vinny sighed and said, “In other words, he needs a frigging babysitter.”
Clalia took his glasses off and pinched the bridge of his nose. “Look, the reality is your brother suffered a serious brain injury, and the facts are that people in his condition are ten times more likely to suffer a concussion after they recover.”
“Ten times?”
“Unfortunately, even if he recovers most of his physical abilities, a very real danger exists. You see, a brain injury is an invisible disability, and if he doesn’t modify his behavior, changing his lifestyle in some ways, he’s likely to suffer what could be a devastating concussion.”
Vinny sighed, reflecting on if Peter would recover and the hole that continued to deepen. “I thought he was here to get better, you know, not to be—”
Clalia held a hand up. “Part of the process is to be informed of the risks going forward, a way to ensure that the progress we make here is kept in the bank, so to speak.”
The physiatrist and Vinny talked for a half hour longer with the focus returning to the importance of Peter’s emotional stability. Clalia continually stressed that the highest degrees of recovery were inexorably linked to avoiding depression, giving Vinny the willies.
Chapter 5
Vinny had been told they were going to start Peter’s rehab immediately, but he was nonetheless surprised when an hour later they came to wheel Peter into the rehab hall. It was amazing to see Peter being lifted by a hoist out of his bed and into a sort of bed on a wheelchair. He was dead weight, but it was good to see him out of bed.
They were met in the bustling rehab area by John Clalia and his staff. The place was noisy and smelled like Pine-Sol. John quickly made the introductions, saying Peter would be seeing more of these people over the next months than he’d care to. Vinny liked the way each of them took his brother’s limp hand and shook it as if there were nothing wrong.
John, whose glasses dangled from his neck, issued instructions, and the group moved Peter to a sort of parallel bars. Vinny doubted they would accomplish much and couldn’t believe his eyes when they maneuvered Peter into a contraption that held him upright between the handrails. Encircled by therapists, they lowered Peter, putting his hands on the rubberized rails and his feet on the ground.
A beefy kid named Roger knelt and straightened Peter’s feet as John said, “Okay, Peter, let’s go for a stroll. Darlene, take a few photos for posterity’s sake.”
Slowly, the hoist inched the grimacing patient forward. Two therapists inched Pete’s hands forward while Roger kept pace with his feet.
“Come on, Pete, take a step. Help us out here. You’re not going to make us do all the work, are you?”
“He’s moving his hands! Way to go, man!”
Excited by the declaration, Vinny studied his brother’s hands but knew there was no voluntary movement.
Clalia lowered his voice. “Anything with the legs, Roger?”
Roger tilted his head up and replied, “A teeny, tiny bit.”
“Good, good.” John turned to Vinny. “Don’t worry. It’s normal. He’s doing great.”
***
The exercise session lasted fifteen minutes before I ran out of steam. I was hopeful at first, but realized I was a virtual prisoner of my body. It had to be depressing for Vinny as well, and I caught a glimpse of him cursing as they wheeled me out. I was so beat, I drifted off to sleep.
I don’t remember getting put back in bed, but they told me I’d napped for two hours. They got me up, fed me a snack, and then helped me brush my teeth. When a mirror was propped up on the tray, I was glad to see that my hair had grown enough to cover the gap between my head and ears. Refreshed and belly full, I felt ready for a series of tests to determine my cognitive state—doctor speak for memory, language, executive function, and visuospatial capabilities.
My elaborate wheelchair was rolled to another wing of the hospital. Contrary to the hustle and bustle of the physical rehab area, this place was a sedate suite of rooms with classical music playing softly in the background. I immediately thought of a funeral parlor and began to get worked up, but a neuropsychologist named James and his smiling female assistant noted my anxiety and quickly put me at ease.
“Peter, we’re here to get an idea of what areas need attention. We’ll administer some tests, but don’t worry. It’s early, and your injury is still healing.”
I nodded, but frankly, they smiled so widely it was distracting.
“Most of all, please don’t get frustrated. Things that you may not be able to do today will come back quicker than you think, okay?”
Really, easy for you to say. I certainly didn’t like the way this sounded, but not knowing what to do, nodded anyway.
“Let’s begin over here.”
The doctor held up a red square. “What color do you see?”
“Uh, uh, rrr, red.”
“Excellent.”
The doctor went through six colors, and I nailed all of them. My spirits skyrocketed, but a problem arose when the doctor would show a color, hide it, and ask what color it was. When he did that, my success rate quickly went down by half, and I got irritable. Rather than risk further frustration, the doctor moved on to another test.
The doctor showed me a picture of three animals and pointed at them. “Is this a cat? Dog?” Most of the identities I picked out. I mean, geez, they’re animals. However, when the doctor would ask whether a certain animal was left, right, or in the middle of the picture, I got real confused and failed miserably. How the hell could I be screwing this up?
I was getting tired of all the bullshit when they moved on to a test identifying various shapes.
Surprisingly, I was able to identify each one correctly and was even able to recall most of them within ten seconds of seeing it. However, when the doctor lengthened the time to twenty seconds between seeing the images, I faltered, unable to recall even one shape.
The roller coaster continued. I did well in the language area, at times jumbling the order of words, but the doctor was clearly happy. I couldn’t get enthusiastic. Maybe I was getting tired.
The last testing zone was visuospatial, to gauge how I interpreted what I saw. The doctor pulled out two props: a clock where he changed times, and two glasses of water with different amounts of water. It seemed simple enough but was a total disaster, exposing, very apparently, that this was an area where loss screamed out.
I tried to pound the table as I spit out a stream of curses. The doctor came around the table and talked me down. Then he thought he was sly, concluding the series of tests with something he knew I’d pass so I would end on a high note. I saw right through him.
“What youse think? I’m stupid?”
“Of course not, Peter. What are you upset about?”
“The last test, a frigging dog could pass it.”
“Come on, Peter, you did wonderfully today. Really, you d
id.” The doctor gave me a thumbs-up. “Nice going. Remember, this is a process. You understand?”
I nodded and forced a crease of a smile out.
“Periodically we’ll run these again, as well as some others, once your arms strengthen.” He put his hand on my shoulder and gave a light squeeze. “It’s perfectly normal to be confused and tired, so why don’t you head for a nap?”
It sounded damn good to me.
***
Walter Reed had a rigid schedule, almost Nazi-like, Vinny would feel when things grated at him, but they wouldn’t let any grass grow when it concerned Peter’s care and rehab. Breakfast was at seven, followed by speech therapy for forty minutes, then a light muscle massage. Then it was down to physical therapy, focusing on the lower body, before lunch. After an hour-long nap, Peter would meet with Clalia before a session of emotional and psychological management with a neuropsychologist. Then it was back to PT, emphasizing the upper body, before dinner at five.
Most days, Peter was so totally fatigued he sleep when not in rehab. Vinny voiced his concerns, but the staff promised the regime would yield results.
It took about two weeks for Vinny’s initial trepidations about Clalia to fade, but his anxiety bubbled. The therapist provided him with daily updates and showed genuine concern for Peter. Clalia continually petitioned Vinny for patience during the process. Vinny relented and could see that Peter was making excellent physical progress, but areas of concern were definitely surfacing.
Walter Reed had its own McDonald’s, and Peter exited it laden with his dinner and the growing fear that his brother’s mental recovery was lagging.
“Yo, Petey, how you doing?”
Peter was staring at the TV and didn’t acknowledge him.
Vinny put his dinner on the tray and tapped his brother. “Knock, knock. Anyone home?”
Peter slowly turned his head. “When you get here?”
Vinny cocked his head. “Just walked in.”
“Is Mom coming?”
“Mom? Come on, Peter, don’t you remember, she passed away?”
“Uh, yeah . . .”
Vinny unpacked his dinner and handed a bag of fries to Peter. “These are yours.”
“Mine?”
“Yeah, you asked me to get you French fries.”
“I did? I don’t like fries.”
“Geez, yes you do. Do me a favor and just eat them. All right?”
Peter put the bag on his tray.
“Did Mary call?”
“How would I know?” He took a bite of his Big Mac instead of running out of the room.
“I want a phone. Why don’t I have a phone?”
Vinny shrugged and continued eating.
“Where’s my fucking phone!”
“Hey, take it easy. You want a phone? Here, use my cell for now.”
Peter took the phone and stared at it.
“What’s the matter?”
“Uh, I don’t, uh, remember her number.”
“Whose number?”
“Stop playing with me. You know who.”
“How the hell would I know her number? Look, I’ll find out, and tomorrow we’ll call, okay?”
Peter barely nodded.
Vinny held a get well card.
“Hey Petey, here’s a card from Mrs. Norton.”
“Who’s that?”
“The next-door neighbor, the brown house, her husband is Bob.”
Peter nodded.
“When you get this?” Vinny picked up a shiny cane that was next to a walker.
“Clalia brought it today. Said I’m about ready.”
“Man, it’s light but strong.” Vinny tapped it on the ground and read the label. “Made out of some titanium alloy. Geez, everything’s so damn hi-tech today. Man, it’ll be good to see you using this.”
Peter shrugged and turned his attention to the TV.
The next evening, Vinny carried his dinner up from the cafeteria, hoping that Peter had either forgotten about calling Mary or would fall asleep as he ate dinner, as was often the case. Disappointment was routine for Vinny, and before he could put his tray down in his brother’s room, it visited again.
“You get the number?”
“Yeah, I got it.”
Peter smiled. “Good, come on, dial it for me.”
“Can’t we eat first?”
Pete shook his head. “Now!”
“Shush, already.” Vinny pulled a scrap of paper and his phone out, dialed, and handed the phone off. “Just push dial.”
“What button?”
“The green one.”
“It’s ringing.”
“Whoop–de–do.”
“Mary, Mary, yeah, it’s me, Petey.”
Vinny strained to hear what she was saying.
“I’m doing good, real good. When you coming to see me?”
Vinny cringed at the thought of her coming.
“Oh, oh, that’d be great. I just can’t wait.”
A brief silence was broken when Peter spoke.
“Mary? You still there?”
“Oh, okay, okay. You know I’m missing you. I mean, I miss you so much and, and I love you.”
Vinny watched Peter’s beaming face quickly darken.
“Okay, see you soon. I love you, Mary.”
Vinny took the phone back. “So when’s she coming?”
“Next week, she said she’d try. She’ll call you to let you know.”
Vinny grabbed a forkful of food. “Eat.”
“Ain’t hungry.”
“What’s the matter?”
“I don’t know, she sounded different. And when, you know, I told her I loved her, she said she knew.”
“So?”
Peter stared at his lap and said, “She didn’t say it back.”
“Look, things are different now.”
“What do you mean?”
“You know, time passed. Things change. That’s all. Now eat, you need your strength.”
***
I graduated from a walker to using that special cane and had regained good stability when walking. It was still a struggle if I tried to jog, like on the treadmill, but the doctors were confident it’d get better. Besides the buzzing in my ears, some sensitivity to bright light, and a metal taste in my mouth, a big problem, where the going was real slow, was my eyesight. It was better than before, when I couldn’t see jack shit unless it was right in front of me, but a long way from normal. Annoyingly, every time I reached for something, I just couldn’t get it the first time, so they set me up to see a specialist when my vision progress hit the wall.
Vinny and I went into a darkened room, and the doctor, an Austrian dude with an accent, had me sit in each of several machines that lined the wall. When he said my name, he hung on the first syllable, making it sound like Peetur. He reminded me to keep my chin in each of the machine’s cups, elongating my name each time. I kept forgetting, and after a while it must have bothered Vinny, because he put his hand on the back of my head and pushed me forward.
The doctor reviewed the test results and asked me to stand. I struggled before reaching for the cane.
“Okay Peetur, sit back down and get up, but close your eyes.”
“Can I, uh, I use my cane?”
“Sure.”
Surprisingly, I got up without much effort.
“Now close your eyes again and try it without the cane.” He reached out and took the cane. “Don’t worry, Peetur, I’m right here to help if you need it.”
I got up pretty easily, just wobbled a bit.
“Good, Peetur, good.” He handed me the cane and took a pen out, centering it on my face. “Now follow this and let me know when it disappears from view.”
He moved it to the left and right and up and down before commenting, “You’re operating with a fair amount of peripheral vision. Your left eye is significantly weaker, though.” He curled a finger. “Follow me.”
We went into another low-lighted room where a large, blac
k disk with red lights occupied an entire wall.
“This tests the peripheral vision with a reaction component. It not only measures if you see it, but when your eyes focus on it and react to it.”
There were two foot imprints on the floor, but the doctor dragged over a tall chair.
“Sit Peetur. This is not a stability exercise.”
I took a seat.
“Now, lights will appear randomly on the disc. As soon as you see a light, move your closest hand toward it.”
He turned on the machine and demonstrated. “Understand?”
I nodded, and, at the count of three, he flipped the switch. At first it was pretty easy to get my hand in the right direction, but the speed increased, and it was really challenging. Still, all in all, I thought I did well.
“Okay Peetur, one more test, and we’re done.”
We went back in the room with the machines and sat at a narrow table. The doctor gave me a small aluminum rod.
“What I want you to do is stick the rod inside each of the objects I hold up. I want you to try to do it with each hand.”
He took a ring the size of a hula hoop from under the table and held it up. My first thought was this was some kind of a joke, but then I panicked when the idea that I might not be able to do it surfaced. Fortunately, I was able to do it easily with both hands. I did other tests, and my confidence built. Then the doctor pulled out a pie-sized ring. I poked through with my right hand but hit the rim with my left, but I still made it in. We stopped when I couldn’t get either hand to pierce a circle the size of a tennis ball.
The doctor opened a drawer and took out a pair of glasses that had one lens blocked out.
“Put these on, Peetur.”
Then he held up the pie-shaped ring, and I was able to do it with both hands, and I successfully worked further down in size.
I could insert the rod into the tennis-ball-sized circle with my right hand this time, but not the left.
The doctor put the props away and nodded.
“Peetur, you have a couple of problems: peripheral and reactionary, but depth perception is affecting you the most. Luckily, the lack of depth perception is limited to your left eye. It is really more than just a lack of, it’s, well, I’ve seen this in other TBI cases. Somehow the brain mixes the data it receives from each eye. In many cases the strong eye, say in vision, will compensate, but it could be the injury caused some damage that may or may not come back.”
Am I the Killer? - A Luca Mystery - Book 1 Page 4