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Broca’s Aphasia

by John Malone

Why was Rosie the dog scratching at the closed bedroom door? Or, rather, why was the white, furry thing with the licking tongue and anxious, pawing feet trying to get into our dark bedroom? Because I did not really think of the word “dog.” Somehow I knew I had to open the door to stop the commotion outside. But why did getting up and opening the door require so much effort? I felt so heavy and weak, unsteady on my bare feet on the cold hardwood floor.

I groped in the dark for the door handle for what seemed like a long time, fumbling first on the wrong edge of the door, the one attached to the hinges. Finally, my fingers closed around the cool, smooth metal, or were they my fingers? Was it a “handle?” The door opened, and Rosie came bounding into the room, jumping into our bed. She was frightened, I knew, but why? I climbed back into bed beside my sleeping wife, with Rosie in the middle between us. She began licking my face and exploring my body with her paws, as if trying to find something wrong.

Finally she calmed down, and we all went to sleep again. But I could not really sleep. Something was wrong with me, I knew. I couldn’t think straight. Every movement took a lot of concentration and effort, as if I were moving my body by remote control from a long way off. I began to panic. I got up again and went to the bathroom, only to discover that I had soiled myself. Take off clothes. Get in little glass room with water coming down. Clean myself. Back in bed. Try to sleep.

We were awake, and Christa was worried, I could tell. Or was she “Christa?” And who was I? Where were we? What day was it? I had no idea. Christa asked me if she should call 911. I couldn’t reply but simply nodded, tears forming in my eyes. I was scared.

She helped me to dress and we went out to the front porch to await the EMS ambulance. Feeling unsteady on my feet, about to tip over, I practiced walking up and down and up and down the long porch while we waited, being very careful not to fall over the edge. Finally they arrived, a man and a woman, both large, strong, gentle people. He was “Michael,” he said, and he gave me an aspirin with his latex-encased fingers. He kept trying to get me to talk, but I couldn’t remember any words. The woman drove the ambulance while Michael wired me up to his computer and began talking on the radio to the new ER at Haywood Regional Medical Center. Christa followed us there in her car. I began to feel relieved.

But there was no neurologist at HRMC that day and none on call. I later learned that the hospital had an MRI machine, but no neurologist would be on duty until Friday, two days later, to read the images. The nurse started an IV and put me on oxygen. Finally, an ER doctor in a white coat with 'Dr. Kelley' embroidered on it in dark blue, showed up. Christa was talking to the doctor and calling people on her cell phone. I knew who they were, but I couldn’t think of their names.

Someone asked me what my mother’s name was. I couldn’t say. I felt ashamed. Christa was crying. She asked me what color her eyes were. It was a memory test, but I cheated. I looked into her red-rimmed eyes and said, “They’re sort of pink!” She and I both laughed for the first time. She sat beside me and fed me pieces of my lunch from a white Styrofoam take-out box. A pork cutlet, mashed potatoes, gravy and corn with a soft roll. I chewed some gingerly, afraid at first to swallow. As we shared the lunch, I felt the nourishment and her love enter me, warming and strengthening me, easing my fear. Doctor Kelley returned. Good news. Another ambulance was coming soon to take me to Mission Hospital in Asheville.

As the ambulance bounced along I-40 East, the EMT, this time a woman, kept up a steady conversation, trying to engage me. I did the best I could to reply, but kept hitting blank spots. Did I know what day it was, what year? No. But a few names were slowly coming back to me, emerging from the fog in my brain. The children, my sisters.

Lying on my back, I watched beautiful fall leaves, clouds and sunshine rolling by the ambulance windows while the woman kept talking and checking my vital signs. It was a strange, blowing, blue and white sort of a day out there, promising some rain at last.

I arrived in room A-625 at the Stroke Unit on the sixth floor of Mission Hospital at 2:30 pm on Wednesday afternoon, November 14, 2007. I only know this now because it was printed on the ID bracelet attached to my wrist for two days. Christa came a little later, as did Dr. Alex Schneider, Director of Mission’s neurological services. Yes, I could have an MRI, and Dr. Schneider would read it, but the busy machine would not be available until late that night or the small hours of Thursday morning. No, I could not have a glass of water or anything else by mouth until the busy speech therapist could come and watch me swallow, maybe later in the evening.

The doctor began a full neurological workup. Penlight shining into my pupils, switching up and down, side to side. More questions with no answers. Squeezing the doctor’s fingers. Pushing against his hands. Touching the end of my nose with my eyes closed. Another IV. A wireless heart monitor stuffed into the breast pocket of my hospital gown. Blood pressure 145 over 96, too high. Risk of another stroke. While all this was going on, I was still struggling to speak, to remember, anything. Did I know where I was? Painfully, I made another effort to speak. Mission Hospital? Yes! Christa smiled at the doctor. He smiled back and patted me on the shoulder.

Evening descended, and Christa, satisfied that I was finally in good hands and receiving the attention and care I needed, went back to Waynesville to feed the cats and walk the dog. The orange street lights of Asheville winked on outside the big window, which spread across the entire outside wall of my room. Strange, big sausage-shaped clouds scudded across the sky, hanging dark and low above Haywood Street on the horizon. I couldn’t have said in what direction I was looking, but the eeriness of the fast-moving storm clouds and the twinkling lights framing Asheville’s skyline mesmerized me. A nurse entered the room to take my vital signs again and offered to close the drapes. But I wanted them open, not really knowing where I was but fascinated by the tableau created by the winking lights and their reflection in the low-hanging clouds. As I lay there attached to the IV drip, it was like looking at a version of El Greco’s Storm over Toledo with bright orange street lights added.

Finally, I slept.

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©2008 John Malone for
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