by Paul Guest
Unknown to me, my father had toured its three small patient floors and its gymnasiums where physical therapists stretched limbs and tried to strengthen flagging muscles. He was holding a packet of information given to him during his visit. Inside were the standard narratives, the smiling faces, plausibly vague assurances. He showed some of it to me.
“This is where you’ll be going,” he said. “Your mother and I decided this was best. That we’d be close enough to visit. Every weekend. It’s not even two hours away.”
I can’t say that I chose to be transferred to Atlanta, to Shepherd; the decision was too large, too crucial, for a child to make. When my parents told me I’d be going there, it was the night before I would have to leave by medical transport, an ambulance, and though I felt small, too small to even cry or feel much fear, unexpected relief opened up inside me. Ten days had passed since my accident, during which I’d slept little, was often unable to eat. I’d been forced to consider a changed life before I even knew what a life could fully become.
chapter THREE
When I left Chattanooga behind, the ambulance drove slowly over interstate rumble. I was lightly sedated and slept all the way. In their station wagon, my parents trailed behind. I had no particular vision of where I was going, what it might look like, or even what might happen to me. Physical therapy, yes, which had been given to me sparingly in Chattanooga, but before it could in earnest begin at Shepherd, I knew surgery on my spine might wait for me. I knew this only as an abstraction: I had worried at its possibility all along, its potential for pain, the inescapable fear that something could go wrong. Over all this, I’d fretted silently, during the long days and nights, and when the doors of my second ambulance opened in Atlanta, the stretcher that held me was rolled out and into the lobby, where elevators opened like mouths.
A space in a room on the third floor was reserved for me. Quickly transferred from the stretcher into the hospital bed, identical to what I’d had in Chattanooga, and identical to the one I’d sleep in, alone, for twenty-three years, I waited. And waited. My parents had found their way before long, sitting in wooden chairs at my side. My father chatted idly, rambling as he did when nervous, and my mother nervously pushed errant, oily hair from my forehead. I hadn’t showered in ten days, no more than sponge baths, not since the night before breaking my neck.
Nurses circulated in and out of the room, recording vital signs, giving papers to my parents, speaking to me, looking at me hard, taking quick measure. No one said very much. I was now in a triage-style suite sectioned into four living spaces separated by ceiling to floor curtains. A little television on an adjustable arm hung from the ceiling. I had one small closet and no desk space. It held the two essential items of my life: a bed and a wheelchair. Anything more was incidental.
My mother began tacking get well cards and pictures of family to the wall. She hung my few clothes. My father talked about weather, traffic, all the cars running down Peachtree. After some time, he trailed away, stood up, and asked if we wanted something from a vending machine.
This is the narrative of convalescence. How it begins. It is familiar to anyone who has stumbled into its uncertain stream: nothing you can say has much weight. Every word is spoken across a distance. The moment you become ill, the instant injury divides you from your life, from the world, from the ones you love and who in return love you, you are floating away from everything and everyone, on numbing ice, desperate for some vestiges of consolation.
The suite was fully occupied by three other patients, though now it was empty. Only us. Outside the room and down the hallway, towards the nursing desk, were the gymnasiums filled with raised mats and modified exercise equipment. I could hear the grunts of effort and the clack and whir of electric machinery, wheelchairs coursing about, and the gauzy whoosh of respirators. Moans, too, floated down the hallway, ghostly, full of pain. We ignored it all, waiting.
First to enter the room was the man who slept across from me. Older, past his middle years, with white hair that stood coarsely up from a pink scalp, he pushed along his wheelchair with wheels that had pegged spokes; his hands were curves, claws, his fingers paralyzed. He pressed against each peg with his palm and slowly went. A nurse walked behind him, pushing lightly. The man had no strength in him and no words, either. He went to bed, where much of the time he’d stay, his skin plagued by sores that would not heal. Before long, I’d learn the currency of that sad realm was the story of your injury, what happened to you and how and why and every other detail in forensic completeness. I’d learn that he, his first name Forrest, had fallen into a pit on land he owned, pitched headfirst, alone, undiscovered a long time. He seemed bewildered, lost, overcome by the change in his life, unable to accept it, to ever live again. When I heard, years later, that he hadn’t lived long, had put his gun to his temple and ended it, I wasn’t shocked.
The next, and most significant patient to my time at Shepherd, to enter the room was Josh Anderson, seventeen years old and nearly seven feet tall, all arms and legs and Albany, New York, accent. So lanky he barely fit in a wheelchair, his knees pushed high up, and his arms nearly could reach the floor. As ungainly an experience as disability is, it must have been impossible to be him, to inhabit a body which had been made for basketball, which he had played, to push against the ordinary limits of all the accommodations the world makes for the disabled. His bed required an extension, else his feet hung from the bed. His chair would need to be custom designed, stretched out, stronger than the usual chair and lighter, too. He fascinated me: the five years’ age difference, his accent, and his body which was not so affected as mine. Above the protrusion of his larynx, a white crescent scar stood out, rising and falling when he spoke. I wanted to be his friend, I needed to be his friend, before we had even met. My parents would soon leave, forced to return to jobs and younger children, promising weekend visits. Soon and very soon.
Josh could push himself around and came over to us, gliding to a stop. He introduced himself. His voice rang in that awkward register of adolescence. He was funny, kind.
“You’ll like it here,” he assured me. To my parents, he said, “Don’t worry, I’ll look out for him.”
A teenager’s boast, sure, but at that time, it was something to hold on to, and it meant all the world.
Here, there was no hesitation. Here, the holding pattern my life had been in ceased and I was immersed in the reality of my rehabilitation. Both broken arms were quickly put into casts. The collar that had supported my broken neck was only a temporary fix. A dangerous one, in that it really didn’t fix anything. It was time to consider real treatment, which primarily meant surgery, in which my vertebrae would be fused using a graft of bone chiseled away from my hip. The disc between the vertebrae would be removed, making room for the hip bone and screws or wiring to hold it all in place. The surgery was painful, invasive, but one other option existed.
That option was to place me in a fiberglass vest, lined with lamb’s wool, with four steel bars connected to a metal ring around my head. That ring would be bolted with fierce inch-long screws into my skull at each temple and in corresponding positions at the back of my head. The effect of the contraption is to completely immobilize the spine in its correct alignment so that any damage may heal. The halo, as it’s called for the ring, is a gamble of sorts, hoping the body is able to heal the vertebrae naturally.
Maybe because it was the best choice, or maybe because I was so young, my body barely touched by the hammer stroke of puberty, the halo was bolted into my head soon after I arrived. I’d live this way for eight weeks at least. Most patients underwent the process while awake, the sites for the screws deadened by local anesthetic. The thought horrified me, the imagined sensation of four thumb-long bolts being turned, crank by audible crank, steel into bone.
But an X-ray spared me.
My left arm had begun to knit crookedly and would have to be rebroken, set again, a plate screwed into the radius, the bone running down to the thumb. This s
urgery would be performed and then the halo fastened to me. I would be under general anesthesia.
The operating room was cold and green and everything else was bright. In an anteroom I waited with soft music drifting down like blandness itself. Curtains circled me. When a woman came to my side, wrapped in scrubs, her mouth covered with a mask, I was grateful.
She pressed a latch at the bottom of the intravenous bag hanging over me like a transparent cloud.
“Can you count backwards from one hundred for me, sugar?”
“One hundred…ninety-nine…ninety-eight…”
All the sound in the room went weird, like it had shape, and then that shape was turning fluid, running out of mind like molten wax. I was gone.
When they rolled my sleeping body from recovery, my mother saw slender threads of blood running back from my temples into my hair, to dry unseen.
When sensation began to return to my body, it was late at night, and in bed I was watching television. All lights out. Volume low. Johnny Carson. It felt like water on my chest, a dew on the skin above my sternum evaporating into the air. No warning had preceded it. No hint. One moment there was only the numbness that had been absolute and unchanging. And then, a tingling like I had come inside from a storm, soaked to the bone, beginning to dry.
I rang the nurse’s desk by blowing into a tube, which activated a blinking light on an intercom. It spoke after a moment, bad sound, cheap and fuzzy.
“Well, what do you need?”
It was Beaver, a middle-aged man who always worked in the darkness of third shift. His manner was librarial, hushed voice cramming all his syllables up so that they uncoiled from his mouth. Someone who didn’t particularly crave the company of anybody else. At night, when it was your time to be turned from one side to the other, or to take medicine, you would wake to find his lined face floating in the gloom above your bed.
I asked him to come to the room. That I needed something. After a long, querulous silence, the blinking intercom light went dark.
And there he was in the dark, looking put out, ill used. He snapped on a lamp and crossed his arms.
“Well, what do you need?”
It was what he always said. Almost the only thing he said. To Beaver, the world was a chain of incessant demand.
“I think I can feel something for the first time. Again. I mean, since my accident.”
“Where?” he asked, his voice now curious.
“On my chest. All across the top part of my chest, like a line.”
“Hmm,” he said. He fished a ballpoint pen from his shirt pocket. “Close your eyes. Don’t open them. Don’t peek. Don’t waste my time.”
I closed my eyes. I waited. I waited.
“What do you feel?” Beaver asked.
“Nothing.”
“Now what do you feel?”
“Nothing.”
“That’s good. And now.”
And there it was, the cold tip of the pen running across my skin. It traced through the water feel, a straight line through what had long been blankness.
“The tip of the pen. In a straight line, left to right.”
Beaver didn’t say anything for a moment. Then I felt the pen pressing into my chest, not like I’d always felt, not like normal. Less apparent but there. There.
“The pen. Not moving. Right?”
I opened my eyes. Beaver was slipping the pen back into his breast pocket. His face gave no hint of what he thought.
“Yep. Right. Congratulations. Go back to sleep.”
He dimmed the lamp and left me there in the darkness. The strange feel of water persisted, tingling, pooling up, a mystery.
Doctors always came by too early. In chatty packs, thick clutches of patient records in their arms. Most days I waited for them, already awakened by the sunlight that came through the wall-length windows and metal slats which did little but hang there. We’d perform our perfunctory exchanges, pleasantries, good-morning-and-did-you-sleepwells, before settling into what one of them called “the brass tacks.” They would look me over, take blood pressure if a nurse had not yet been by to do so, peer at the urine which had collected overnight in a bag hanging from the bed frame. In it, they scanned for signs of blood, darkness, sediment. Last was usually close inspection of the halo jacket I wore, checking the skin underneath the fiberglass vest for signs of rash or irritation or infection. With cotton swabs, they probed the sites where the halo was bolted into my skull, applying Betadine, a muddy red disinfectant, and some days produced torque wrenches to tighten the bolts. The sensation was sickening more than painful, and on those days I dreaded the weirdness of it.
But the morning after Beaver had dragged a pen over my skin, there were more of them than was usual. One of them spoke.
“We hear there might be some changes going on in here.”
I said yes.
“Mind if we take a look?”
Even if I did mind, I had no power to stop them, or anyone, from putting their hands on me. Disability isn’t so much about the loss of control as it is about the transferal of it. From yourself to someone else, to loved ones, strangers. To devices.
Sure, I nodded.
He brought out something which looked like a small wheeled pizza cutter. On the wheel were pins of varying sharpness. He flicked it and the wheel spun a bit.
“Where exactly are you feeling something?”
I explained to them, the weird tickle that still was there, just above my sternum. He took the wheel, placed it on my chest, and began to push it across my skin.
“Tell me what you feel,” he said. “Sharp, dull, sharp, dull, sharp, sharp, dull, dull. Whatever it seems like to you.”
The difference, then, was negligible, barely perceptible. I closed my eyes, trying to concentrate, but it made the sensation no more apparent, just strange, disembodied.
Several minutes passed that way. At best, I was uncertain of any differences, and could only feel the wheel pass over that part of me. The rest of my body was still lost, and even though I’d soon grow to hate that probing, its ephemerality which only grew with your eyes closed, it was cause for hope, a dangerous thing, an untruth not quite uttered.
You enter this place, this junkyard of bodies, where at night the hallways are humid with the vapor of shower water, and the stink of shit, when nurses pass from room to room, their hands ghostly white in latex gloves. You enter this place, more than half dead, wanting to go back out just as you were before, as if this were somehow possible, bearing up in your arms the weight of your old life, carrying it just as you ever had.
You enter this place. You enter this place. And you wait.
For your body, for your nervous system, for the manifold nerves which comprise it, to do something, to do anything, for your faithless skin to pebble with gooseflesh in a draft of cold air, for one muscle out of the six hundred gone slack to convulse back to life, for the most desperate fears within you to recede. And whatever it is you fear, and all of it is elemental, whether you’ll walk again or dress yourself or eat without help or, you hardly want to think it, make love, all those fears are not assuaged by your time here. Those fears are systemically stoked. By instruction and by harangue and by slide show and videotape.
You must not become what you most fear.
chapter FOUR
“I swear to God,” said Gary. “This big. Like a basketball. I looked down and—”
“And what?” I asked, bumping up to one of the tables where meals were served.
Gary, an African-American man in his late forties, had been gone for a couple of days, and no one knew where he had been. Back in his bed and hooked up to an IV, he had recovered enough to join us for breakfast. That morning, his voice sounded even more gruff and abraded than usual. “Never you goddamned mind. You mind your own concerns. That’s what you do.”
He spoke like that, irascible, profane, and never cared much for my presence, as young as I was. Gary had almost bled out in a gas station parking lot after being shot
by a stranger. The bullet had severed his spinal cord, exiting his body through the back of one of his lungs.
“No, seriously, what?” I asked again. “I wanna know what you guys are talking about.”
Seated beside Gary was Josh, all angles, his face mapped by acne. He grinned, amused with Gary, with my confusion. He waved me off. Later, he said. Later.
Down to the table’s end I went, not far from them, feeling sullen and waiting for a nurse who’d feed me dry toast, some grapes, orange juice from concentrate. I could see Josh laughing, his face fixed with a conspiratorial grin. I had no idea what they were talking about. Why I could not hear it.
I suffered no less than any of them, was more acutely affected by my injury than most, in fact, and yet I was the scrawny kid held at a remove, outside real fraternal bond.
“That’s not normal,” Josh yelped, his eyes wide.
Gary was nonplussed, now stirring his moat of grits with a spoon.
“On a stack of Bibles, my man. On a stack of Bibles.”
Later that night, after therapy, when we were in our beds, speaking through the swaying wall of curtain between us, Josh explained to me what elephantiasis was. The thought of Gary’s grotesquely swollen testicles was not so hard to countenance: all around me were proofs of frailty. I was one. I thought of my own body swollen that way and a swimmy feeling spilled into my head. It was funny, we laughed, but underneath it all, miniature horror percolated. The body was all difficulty, compromise; it could never be sublime.
As if the malfunctioned fact of our bodies were not lesson enough every day, we were required to attend classes, six weeks of them, during which we mostly watched weird videotapes. A television set and VCR were set up in a lounge, all its furniture removed, for us to herd our wheelchairs into. And then it would begin, the tape viewed so many times, lines ran across the picture like gaps through which all the color had slowly seeped. Each one focused on a particular body system, the bladder, the bowels, whatever now no longer worked all that well. They were awful, without exception, anthropomorphized to the point of absurdity. In one, a poor actor gamboled about in a costume meant to be a bladder, his arms ureters. In another, the long rope of the intestines was portrayed by a sad troupe, bound together in an organ-esque fabric tube, dancing in clumsy lockstep with the rhythms of our disrupted, dysfunctional digestive system.