by Steve Boman
This time, when I open my mouth, some words come out. I focus on every word. It is like lifting boulders. “I. Didn’t. Feel. Good,” I explain.
Irene has a big medical dictionary on the kitchen table. The book is open to a chapter titled “Stroke.” She tells me I need to call my doctor, pronto. I shake my head. I don’t need my doctor. I obviously have only a bad case of the nerves. I only need more bananas, a couple of big glasses of cranberry juice, and a little exercise to clear the cobwebs out of my head. I am going to jog it off. Then I lace up my running shoes and head out into the warming Southern California morning.
L
ater that day, I am flat on my back and being inserted into a massive MRI machine at UCLA Medical Center. I have driven myself to the Emergency Department at UCLA and explained to the triage nurse that I had briefly lost my ability to talk and read that morning. I act very casual when I tell the nurse this. I lean on the counter, suppressing a yawn. I figure if I’m not excited, she’ll send me home and everything will be okay.
I did indeed make it to orientation that day. I drove myself to USC, sat through the same speeches as a few years earlier. I sat next to Dan. A woman asked me if I was a father. I took it she meant Dan’s father. “I’m a father,” I told her, “but not in the way you’re thinking.” That’s about all I remember. My head was foggy, that’s for certain. After orientation, my middle brother, an internal medicine doctor, caught wind of what was happening and ordered me to an emergency room. This put a fright into me, and I headed for UCLA. I got lost going there, even though I am very familiar with the area. At one point I pulled over to gather my wits, and after I wandered through Westwood I finally located the hospital.
Unfortunately, I didn’t spend long in the waiting room. It’s a bad sign when you’re whisked ahead of the two dozen other people wanting to see a doctor.
Not long after I am put in an exam room, a nurse comes to see me. He’s a muscle-bound black ex-marine, and he soon has a soft spot for me. We’re the same age, we both have kids, and he’s studying for his PhD in nursing. He is impressed I’m enrolled at USC. He knows what the doctors are looking for in my brain, and he promises me he’ll watch over me. Before he leaves, he tells me his dad died of a stroke when he was just fifty-two.
The minutes tick slowly. I’m alone, waiting for the MRI results. Then the muscle-bound nurse comes in. He clasps my hand. “I saw the results. I wanted to be the first to tell you. You had a stroke.” Tears well up in his eyes. We hold hands for a long time. I am terrified. A stroke? Really? It seemed unbelievable, inconceivable. I could understand getting cancer, or getting hit by a bus, or maybe being eaten by a shark … but a stroke? Gimme a break! I am healthy as a mule! Strokes are for old people, really old people, right? My dear grandmother had a stroke when she was in her late eighties and her arms were flabby and soft as pillows! I just spent a summer waterskiing at 5:30 A.M. and jack-hammering out a wall in my basement. I am fit as a freakin’ fiddle!
Just then a female neurology resident skids into my exam room. She looks very young. I wonder how long she’s been out of medical school. “I … hear … you … had … a … stroke,”
she says with deliberate slowness. “Can … you … understand … what … I’m … saying?” I debate mumbling some slurred nonsense to her, à la Jack Nicholson in ONE FLEW OVER THE CUCKOO’S NEST. But I don’t. For one of the few times in my life, I have no desire to joke. I just feel scared.
I’m wheeled in my gurney out of the emergency room into some elevators. I keep telling myself, “This is just a nightmare. This is just a nightmare.” I pinch my legs to see if that will wake me.
We come out of the elevators. I see a big sign in the hallway: Stroke Unit.
The gurney’s wheels squeak as we roll down the quiet corridor. I look into the rooms. I can’t see much, a few legs under blankets. That’s about it. Everyone is sleeping.
At the end of a long hallway, the nurse pushes me into the last room on the left. It’s a shared room. I hear the beeping of a heart monitor from the patient in the bed next to mine. I hear my roommate stir. He moans a bit. I can’t see him because of the room-divider curtain.
I feel super fucking agitated. I can’t believe I’m here. I want to jump out of the gurney and run for the exit.
“How do you feel?” asks a nurse.
“I’m super fucking agitated,” I answer.
“Would you like something to calm you down?”
Would I? Of course I would.
She gives me a pill. I swallow it. “This will help,” she says.
With the two-hour time difference, it’s now 4 A.M. back in the Midwest. Julie is on a trip with the girls to visit relatives in Wisconsin. Her cousin is getting married. Julie is staying with her grandma in a little two-bedroom house in a tiny farm town in eastern Wisconsin. The idea for the trip is to give the girls a little vacation away from home to soften the shock of my being gone for months at a time. I don’t want to wake everyone with a phone call in the middle of the night. I’m not going anywhere, so why cause everyone more worry than necessary?
I lie in the bed, waiting. I think over my reality. I have had a stroke. It is an ischemic stroke. Something blocked blood flow to part of my brain. The doctors don’t know what caused it. They don’t know if I will get another stroke. I am hooked up to an IV with blood thinners. Because the symptoms abated quickly, it seems the clot dissolved before it did any lasting damage.
I know enough about strokes to know they should not happen to a forty-two-year-old man, especially a fit and healthy forty-two-year-old man. I don’t smoke. I don’t do drugs. I have zero risk factors for a stroke. I just ran eight miles in under an hour the week before I left for California, and it was an easy training jog.
And now I have had a stroke. None of it adds up. I wonder how it happened. My mind wanders to all of the stories I know where someone feels fine one day and the next they fall into an abyss.
My mother-in-law had died a year earlier. One day her legs started to hurt. Not long after that she went to the hospital. Within a few hours, doctors found massive numbers of blood clots in her legs, clots created by the cancer eating away her lungs. She never smoked, and had no risk factors for lung cancer. Three months later, she was dead. One evening, my younger sister, Annette, went to the emergency room because she had a painfully sore hip. Within a few hours, doctors discovered she had an aggressive form of leukemia. She lived for only four months. A decade earlier, my friend Shawn went to her doctor because she had a bad cold that wouldn’t go away. She learned she had cancer. She died within the year.
I know cancer can cause blood clots. My mind keeps coming back to the word: cancer, cancer, cancer.
I wait for the pills to kick in. They don’t. I hear my heart monitor beep. I hear my roommate’s beep. I look at my watch: 2:30 A.M.
I speculate where my terminal case of cancer could be hiding. It wouldn’t be something obvious, like a brain tumor or that would have been picked up in the scan. It was unlikely to be leukemia, I thought, because I had no other symptoms. I finally settled on my gut. It must be some quiet tumor growing silently in my liver or intestines or stomach, thriving on the junk I put into my mouth. Lord knows I feed it enough crap: Gummi bears, bourbon, Big Macs, sour cream ’n’ onion potato chips. I don’t like most green veggies. I don’t eat an apple a day. I even lie to my dentist about flossing regularly. For years I’ve felt my body has been an unbreakable V8 that will run on whatever crud I put in the tank. I pour calories in, and it keeps going. Until now.
I wonder what my friends will think when they hear. I know they won’t believe it. They think I’m an Iron Man.
I think back to when I was nineteen and my brother was in the air force. It was July. I had helped him move to Colorado Springs. In the back of the moving van was my motorcycle. After a morning of unpacking, I gave my bro a hug and I got on my Kawasaki and rode like a demon in ninety-five-degree heat, sometimes shirtless, at eighty and ninety miles per hour. I rode throu
gh the night. I made it to Minneapolis, 980 miles later, and ran the Hopkins Raspberry Run five-mile road race the next morning with my pals. Then we went to a pool party. The next day, I rode another 180 miles and returned to my job painting houses.
And now I lie on a hospital bed, wondering what is next.
The heart monitors beep.
I don’t want to think about what my family will feel when they hear the news. When I think of my children, I begin to feel panicky, so I push the thought away. I don’t want them to know Dad had a stroke. The thought sets my adrenaline rushing and overwhelms any effect of the sedative the nurse gave me. Five years earlier, Julie had gone through thyroid cancer treatment. I was the strong one then, the one who didn’t get ill. Now I’m hooked up to an IV, and nurses come every few hours and check to see if I’ve had another stroke.
I feel guilty lying in a hospital bed. A blood clot got stuck in my brain. I can’t believe it, no matter how many times I think it. How f’kn’ lame!
Finally, my watch hands crawl to 4 A.M. That means it’s 6 A.M. in the Midwest. I dial Julie. Her cell rings a long time before she answers. I woke her up.
Hey, honey, I had a stroke. I’ve been admitted to the UCLA hospital.
There is a silence on the line.
When I was in elementary school in Duluth, I had a friend who lived about a mile away. In between our houses there was a path that led through the woods. We played together almost every day after school, and no matter whose house we were at, we would walk together to the edge of the woods. In the winter, when it was dark, we would walk together into the center of the woods, trying to ignore the darkness and the fact that behind the trees there were almost certainly bears and wolves and crazy madmen waiting to rip us to shreds. Then, in the middle, we would part. We would yell to each other as we each walked our respective ways.
We maintained this call-and-response until we were at the edge of shouting distance. Then, one of us would yell: Watch out for bears! And with that, we’d start sprinting. Through the dark woods we’d go, running as fast as our eleven-year-old legs would take us. When we hit the lighted streets, we’d feel safe again.
I had hoped Julie’s voice would make me feel safer. But when Julie collects herself and speaks, I feel vulnerable. I’m suddenly more scared than I ever was running through those dark woods in northern Minnesota. It was all imaginary fear then, and in my childish heart I knew that. Now it is real fear. I am in a hospital room in Los Angeles, two thousand miles from home. We have three young children, and here I am, failing them. I had convinced Julie it was a good thing for me to return to USC, and on the first day—the very first day!—I’m in a hospital bed.
She asks me what I need her to do.
“Oh, I’m fine. They could release me any time.” I’m lying. I tell her to wait until I know more. I say I don’t know what is holding up the hospital. A few more tests and I should be out, I say, adding that I’m really not that worried. Lie, lie, lie. It’s depressing being alone in a hospital, but I didn’t want to sound weak and needy.
We hang up and my mellow pill begins to kick in. I fall asleep.
I wake several hours later with a troop of doctors standing over me. I am stunningly groggy.
I keep blinking, trying to get out of the fog of my sedated sleep. I understand the scene: it is morning rounds, and the bored attending doctor, doing weekend call, is going to use me as a teachable moment to a handful of the eager residents.
In fact, fifteen years earlier I had been the object of a similar teaching moment. Then, it was funny: just a half year after marrying Julie, I crashed while racing a bicycle. After I picked myself off the pavement, I noticed blood seeping out of the end of my pecker. At the emergency room, doctors told me I had a “fractured penis.” It is a true medical condition. Look it up. A week after the accident, my privates were swollen beyond recognition. I was referred to a urologist at Temple University in Philly. After I waddled into his office, he took one look at my distended manhood and asked me a question: “Could I show this to my residents? This is classic.” A few minutes later, he led in a troop of young doctors just out of medical school. I was twenty-seven. They were about the same age. Four were women. The urologist introduced me, gave a quick explanation of what happened to me, and asked to examine me again. I stood up, and with as much dignity and gravitas as I could muster, lifted my gown, and showed the residents my massively bruised and distended manhood. “Ta-da!” I said.
Now, in a similar setting, I’m not feeling funny in the least. The attending doctor asks me to perform some cognitive and physical tests to see how my brain is working. He moves his finger across in front of my eyes to see if they will track. He asks me if I know where I am. “I’m on the stroke ward of the UCLA Medical Center here in the beautiful city of Los Angeles,” I say. I’m tired.
On a sunny Saturday morning in August, these stroke doctors aren’t full of cheerful banter. I suppose if you spend your weeks with brain-damaged people, it can get a little dispiriting.
The rest of that day is a misery. I am sent out for various scans. I keep waiting for a doctor to arrive with a solemn look and say, “I’m sorry, Steve, we found cancer in your liver/stomach/lungs/pecker.”
My cell phone battery goes dead. The hospital phone at my bedside won’t make calls out of state, but it will accept calls. I’m drowsy. Depressed. My roommate is a twenty-year-old recovering from an awful car accident. Along with broken legs and hip and a ruptured spleen and collapsed lung and a broken jaw, his skull is cracked. He can only mumble through his wired jaw. He looks like Wile E. Coyote after a run-in with the Roadrunner. But his brain seems fine underneath all the broken bones and wires. He mumbles to me that he was drunk when he crashed.
My parents call me. I hear the fear in their voices. I do my best to reassure them that all is well. They lived through the nightmare of their youngest child dying of leukemia just a few years earlier. I know they are panicked. They tell me they will arrange a flight for Julie to come out.
I need a little fresh hospital air, so I take a walk down the corridor. I stroll the hallway in my backless hospital gown and my two-toned cowboy boots.
What a depressing place! I see a guy in bed, drooling. A middle-aged lady is wearing a hockey helmet. Old people stare at the ceiling, oblivious to the TV blaring five feet from them. A dude my age in a wheelchair. It feels like a nursing home. I pass by one room and see teary-eyed family members surrounding a bed. I only see the feet of the patient. It looks grim.
The nurses give me a funny look, but they don’t stop me. I don’t think they’re used to seeing patients stroll through the ward. The ward is surprisingly unkempt. Beds are double-parked in the hall. Medical equipment sits in the hallway. In some spots, there’s barely enough room to get a bed through the corridor. The nursing care, I quickly learn, varies hugely by shift. When I was first rolled into my room just after midnight, I had a wonderful nurse—caring, efficient, quick.
But in the afternoon, my nurses are awful. I return to my room and watch some television, and an alarm by my roommate’s bed goes off. It rings and rings. No one answers. He hits the nurse-call button. No one comes. I hit my call button. Nothing. Finally, I get up and put my boots back on and walk down the hall to the nurses’ station. A trio of nurses are lounging at the desk. It sounds like they’re gossiping. I tell them about the alarm. One huffs up from her chair and heads off to our room at the end of the corridor. I seem to be the only ambulatory patient on the ward.
At midafternoon, I’m wheeled down for an ultrasound of my legs. My doctors want to see if there are clots there. It’s dreary in the hospital basement where the scans take place. The technician says everything looks fine with my legs.
Later, I’m rolled in my wheelchair out into a corridor and told to wait for a nurse to bring me back to the stroke unit. The nice ultrasound technician tells me I can’t walk back to my room; I need to stay in my wheelchair. Hospital rules, she says. I kill time by doing wheelies i
n my wheelchair. After fifteen minutes of wheelies, I get impatient and roll myself to the elevators. I get in and push the button for the stroke ward.
I sense most stroke victims don’t demand a lot of pampering. Still, I expect better, especially at UCLA, which touts itself as having one of the premier stroke centers in the world. Back in my room, I climb back in my bed and, feeling sleepy again, settle in for a nap. In the middle of my dream—I’m on a lake with Julie and the kids on a summer day, swimming—I’m awakened by a nurse getting my vitals. She’s upset.
“You were supposed to wait for transport after your leg scans!”
I’m not a good fit for this stroke unit. The nurses seem to want me to be more brain-dead.
The day stretches on. Carl and Irene visit, and they have more bad news. Sometime Friday evening, a water pipe in the bathroom near my bedroom burst. They were both gone when it happened. It flooded an entire wing of their house, including my bedroom. The carpeting and sheetrock are destroyed. The confluence of events seems spooky and weird. My brain plumbing had a problem Friday morning. Twelve hours later, their house plumbing has a major snafu.
My parents call. They have a flight for Julie. She’ll be driving home to Minneapolis from Wisconsin and flying out the next day.
As evening comes, the dreaded visit from a doctor never comes. There is no cancer diagnosis. I should be cheered up, but I’m not.
That night I have wild, strange nightmares. Without the sedative, I’m jumpy as a frog. I bolt awake. Are my hands asleep? Or is it a stroke? My vitals get checked every few hours. I hardly sleep, and then dawn comes and I doze off.
Sunday morning, another visit from the herd of residents and their leader. This time the attending doctor is a tall, older fellow. He lingers at my bedside, answering questions.
He explains that my blood clot was very small, and that I was very lucky to have dodged a bullet. “I think you’ll look back at this and be very thankful this happened,” he says. “It could have been much worse.” He says the cause of the stroke is still a mystery, but he suspects I might have a small hole in my heart—a patent foramen ovale or PFO—that would allow blood to seep into the arteries that go straight to my brain. Normally, blood goes through the heart, into the lungs, where it is filtered of impurities and filled with oxygen, and then sent to the brain. With a PFO, some blood can take a shortcut straight to the brain. If there is a big chunk of impurity—a blood clot—it would play havoc with the tiny vessels in the brain.