(an unabridged and more carefully edited version of the original entry…)
The morning of Thurday the 12th started as they all do. After checking my email, I'd begun laying the foundations for breakfast, which always begin with washing the previous night's dishes. (I usually soak them overnight, to let Time do the work.) I had just begun running the water when an odd sensation came over me. It was a little like when you stand up too fast – my vision started browning out, becoming dim and grainy, like a weak signal on an old black & white TV. Usually this dissipates after 2 or 3 seconds. But after 8 or 10 seconds, during which I became increasingly light-headed, I began thinking this might be something more sinister.
The light-headedness worsened. I felt like I was about to pass out. I staggered and grabbed the edge of the sink to keep from falling. I remained conscious, but was still staggering, and my right forearm had begun shaking uncontrollably. I couldn't make it stop. I leaned against the counter to brace myself.
Holy Shit, I thought. I'm having a stroke.
It was 7:20 AM.
Clutching anything I could for support, I made my way to the end of the galley and took the phone out of the charger. I slid to the floor and tried dialing 911. I could barely see the phone, and my right hand was helplessly tethered to an arm still thrashing around everywhere but where I wanted it to. Hitting the buttons was like trying to change the station on one of those old pushbutton car radios while hurtling along a bumpy road. Whether from panic or something else, confusion was fogging my thoughts, and I was having trouble remembering how to use the phone. By pinching the arm between my body & the wall I managed to immobilize it enough to hit the buttons, but it took several tries before I finally heard the call go out.
"911, what is the nature of your emergency?"
With my back pressed to the door panic was trying to force open, I said, "I think I'm having a stroke."
I gave him my name, address, and described the symptoms. He assured me help was on the way, urged me to stay calm and to remain on the line.
Then it occurred to me that the entries were all locked. I was going to have to cross the vast Saharan expanse of the living room to unlock the front. I couldn't even crawl because my right arm continued to refuse orders, choosing instead to thrash spastically about. I don't remember the journey - but somehow I made it to the entry. I vaguely remember looking up at the lock from the floor and throwing it to the unlocked position (probably with my left hand).
Then I struggled over to the couch and collapsed there. The dog, who'd been watching all this unfold, joined me. He knew something was amiss and lay against me. His body language conveyed unease. I managed to stroke him with the palsied right hand. Somehow it gave us both a little comfort.
Gradually the tremors in my right arm became less violent, and by the time the EMTs arrived they had nearly stopped altogether. There was little to be done until the ambulance arrived, so we made small talk and played with the dog (who happily welcomed their company).
When the ambulance finally arrived, I tentatively stood to assess my equilibrium, and though a little wobbly, decided I could walk. “I guess I should get dressed,” I said.
“They’ll just make you take it off when you get to the emergency room,” one of them said.
So it made sense to remain clad only in my bathrobe & moccasins, but I wanted to have something to wear when discharged later that day; so I rather unsteadily made my way to the bedroom and grabbed the barest minimum of clothes – a pair of jeans, a t-shirt, and a pair of comfortable shoes. No socks, no drawers – I figured I could go commando for the ride home. And I didn’t want to hand-carry any more than I could comfortably manage in my impaired state.
When the ambulance finally arrived, I gave the dog a biscuit, told him to be good, told him I’d be back, and with a little assistance descended the front steps and climbed into the ambulance. Thirty-five minutes or so later, I disembarked, and clutching my meager bundle like a newly-arrived immigrant at Ellis Island, walked to the ER admissions desk.
One of the EMTs did the talking. “Suspected TIA,” he told the woman behind the counter.
TIA. Yeah, I could use a Tia Maria about now, I thought.
I was led to a little cell with a gurney, a couple of stainless-steel framed vinyl chairs, and a frightening array of electronic devices evidently intended to spy upon the inner workings of my body. I was handed a johnny and given a moment to slip it on. (Why do they even bother with those ties? Even if you do manage to secure them, they always come undone. Why don’t they use Velcro instead?)
An ER nurse taped a half-dozen or so electrodes to my chest, clipped a little sensor to one of fingertips, and then left me to my own devices.
The palsy had all but vanished by now, though the visual disruptions remained. I looked over at numerous electronic signals tracing across the screen to my left. The green one at top was pretty obviously my heartbeat - but what of the others? Temperature and respiration, probably. I removed the little clothes hanger thing from my finger, and the white trace flatlined. Ahh, so that’s what this thing does. I replaced the clip and the signal resumed. Which one was respiration? So I held my breath – and the blue trace flattened out. Just to verify it, I hyperventilated a bit – and in response the blue trace increased in both frequency and amplitude.
About this time, an IT tech showed up with a laptop – apparently the hospital’s computer network was experiencing problems. I recognized him as a former colleague from Markem, and after our verbal handshake, I told him how I’d been hacking the bio monitor. He laughed. “They ain’t gonna like that,” he said. “Well, they should know better than to leave an engineer unsupervised near all this equipment,” I retorted. He laughed again and went on to the adjacent cubicle.
I never did figure out what the yellow trace was.
Over the course of the day, I was visited by a number nurses, physicians, and specialists. They basically all had me perform the same tricks: Hold your arms out steady. Grab my fingers. (“Oh, no, I ain’t falling for that one – had an uncle who used to ask me the same.”) Push against my hands. Shrug your shoulders. Blink your eyes. And so on.
No signs of asymmetry, but one test did seem to indicate possible damage to the brain. One of the neurologists asked me to look directly at her while tracking her right hand in my peripheral vision. Then she gradually extended it out to her side across my visual field. As her arm straightened, her hand suddenly winked out of existence. I could still see some kind of background – but it was as if she’d stuck her hand behind a Barrier of Invisibility, like the Klingon cloaking devices of Star Trek.
I’d apparently lost about 1/3 of my left-field peripheral vision – in both eyes. The background I could still see was probably my visual processing centers filling in what it expected to see, like PhotoShopping an average value into a missing pixel.
That both eyes were affected seemed unusual in light of my right arm’s misbehavior earlier in the day, and I said so. Apparently some visual functions are performed by both hemispheres, not just the one on the opposite side of the body. You learn something new every day.
I undertook to explore this new phenomenon. While lying on my back I stared directly at my feet – and sure enough, I could only see the two sections of the gurney’s railing nearest my left foot – above my knees there appeared to be no railing at all. Shifting my gaze slightly to the left, to the far end of the railing, brought more sections in view at my periphery.
I noticed another odd effect sometime during the afternoon. I’d been availing myself of the bathroom across the hall all day, but suddenly the metallic reverberations of the door latch and lock seemed unusually loud and harsh, as though being played through a cheap, overdriven amplifier – particularly in my left ear. Curiouser and curiouser…
It was becoming less and less likely that I’d be going home that day, and as the afternoon wore on I began fretting about Kane. We’ve been inseparable since I adopted him, and I hated the thought of putting him through a frightening separation, much less making him go without food and water for however long I was going to be away. There was a phone by the gurney with access to an outside line, so I tried calling someone – anyone – to look in on him. But everyone I know was at work. I eventually managed to leave a message at my brother’s voicemail, and at around 3:00 finally got hold of my sister, who agreed to take him in overnight. That alone decreased my stress level enormously. I had to laugh at the irony of being more worried about the effect my stroke would have upon my dog than it would upon me.
Finally I was wheeled upstairs to a room for the night. It was a double – but my roommate was bedridden, so I would essentially have the bathroom to myself. And I got the bed by the window.
More tests. A CT scan showed no active bleeders, but lacks the resolution to locate more subtle damage. For that I’d need an MRI later in the evening. More finger-grabbing, more shrugging, more blinking, sticking out my tongue, pressing my toes against outstretched palms… Jesus Christ, don’t any of these people talk to one another??
At around 5:30 I was visited by a scruffy-looking young man who identified himself as an employee of the kitchen. I was overjoyed to see him – I had not only missed lunch, but breakfast as well. I ordered the minestrone, a veggie burger, something else I can’t recall, and a cup of coffee. “Cream and sugar?” he asked. Feigning indignance, I replied, “Nossir. Straight, no chaser.” He laughed. “Coming right up.”
After he left I unplugged the data harness to which I was tethered to get out of bed and go to the bathroom. While in there, I brushed my teeth and gave myself a sponge bath. And when the food and COFFEE arrived… What a difference a bath, a jolt of joe, and full belly can make!
My dog was being cared for. My body was washed, well-fed & caffeinated, my teeth brushed, and I had access to my own cable TV. I even seemed to have recovered my peripheral vision, and the odd auditory effect earlier observed had also disappeared. It was about the best one could expect this sorry event to play out.
My MRI was scheduled for 9:00 pm. I’d never had one before, but I’d been warned what they were like. I assured the tech I was not prone to claustrophobia, and that my musical tastes included classical & contemporary jazz (not the dreadful Jazz Lite so enamored of Muzak, Inc.). She handed me a pair of headphones, slapped the hockey mask over my face and slid me into the tube.
Now that was a trip. The headphones had proven useless over the banging of the MRI, which was just as well, because the tech’s idea of jazz was disco soul-funk. I actually found it amusing that each cycle had its own unique set of noises. When I was wheeled back to my room for the night, I asked for writing materials, and penned a little haiku of the experience:
for power tools
Well, I thought it was funny.
Not quite ready to turn in, I browsed through the TV channels, settling upon the final half-hour of “Air Force One” – a gaudy, cartoonish CGI-fest, but, hey, Harrison Ford and Special Ops. I shut off the tube and the light over my bed, and closed my eyes.
I might as well have tried falling asleep in a bus terminal. As if the constant commotion out in the hall weren’t enough, my rooomie had the endearing habit of pulling off his O2 sensor, setting off an insistent alarm on his monitor. The duty nurses were apparently so used to this that they’d stopped running to see what was wrong, letting that goddamned alarm go on for minutes at a time. Still, I managed to get nearly 90 minutes of low-grade, non-REM sleep that night, ending at 4:00 a.m. when two nurses roused me, one to take my blood pressure, one to take my blood. By 5:30 I gave up all pretense of trying to sleep, and channel surfed for a while, watching the endings of whatever movies were playing.
The sun’s first light peeked in through the window. This was followed by more visits from the neurologist, the cardiologist, the this-ologist, the that-ologist. More alarms from my roomie's bio monitor. An ultrasound of my heart - that was actually kind of interesting. Another cardiologist shaved part of my chest and taped a heart monitor to it, which for the next two weeks will look for signs of fibrillation and beam the data to the mothership in Ervine CA. (Not to worry, it's waterproof enough to shower, provided I don't dawdle under the stream.) I'll be taking as many meds as my mom for a while, and I've got a half-dozen follow up appointments in the coming months. Be forewarned, Medicare - here I come.
The MRI revealed several damage sites (no number was specified), each causing its own mini-stroke. A clot had apparently broken up into a cloud of tinier fragments, like an asteroid hitting the atmosphere and breaking up into a cluster of meteorites. That would explain the apparent presence of both left-hemisphere and right-hemisphere injuries. This, I finally learned, was the meaning of TIA: “transient ischemic attack”.
Breakfast had been late in coming, and I’d stoked up, so when lunch arrived I wasn’t really hungry – a small bowl of tomato soup was more than enough.
The duty nurse assured me I’d be released “sometime” that afternoon, but I assured her that that wasn’t good enough - I couldn’t expect my sister to sit home all day waiting for the call that said “Now! Come pick me up Now!” It took a bit of flogging, but she eventually expedited my release. Karen arrived some time after 4:00, and we were walked out at around 4:30.
Her husband was waiting for us in the car, with Kane standing in the back seat behind him. In the few times I’ve had to leave him in the care of someone else, he’s always seemed very subdued and uncertain when I’ve returned to pick him up. Not this time. When I climbed in beside him, he was instantly all over me, whimpering and licking my face and hands. He was nearly as glad to see me as I was him.
Overall, this was easily the most terrifying face-to-face with my ultimate mortality. Shit gets real.