Fired by my occupational therapist

Today I was fired by my occupational therapist. There are two kinds of therapists that you can see a lot. Physical therapists are responsible for training you in the use of your body with all of its limitations. Occupational therapists are interested in getting you back to a normal life. This may include getting back to work but it also includes many of the changes to get around in your house, to be able to use the kitchen, the bathroom and many of the other facilities that are part of a normal life.

Ever since my accident I have been seen by both physical and occupational therapists. Now that I am an outpatient I have been seeing my physical therapist about once a week and my occupational therapist almost as often. Today my occupational therapist told me that I had mastered many of the skills that she wanted to teach and that barring major new issues I would probably not need your help in the future.

I suppose that I cannot argue. I am working, at least half-time. We have made most of the accommodations we intend to make to the house and I understand the critical issues in making the remaining modifications. We just purchased a car and it is being modified to allow me to drive with hand controls. I am cooking and helping out with many other household chores. I suppose my therapist has a point that a little over four months after my accident, while I still have a lot to learn and a lot to improve, I have established new patterns of my life and they are rapidly becoming a complete story.

Bump, Bump, Bump up the stairs

Ever since the accident I have avoided visiting friends whose houses could be reached only by stairs. When we wanted to meet people they came to our house. The last two meetings of our book club met at our house as the only accessible house in the group. Last weekend I was invited to a party for the Seattle AOPA , and flying organization that I have been a member of for a long time. I found out that the house at which it was being held was up a staircase with eight or nine steps. I also knew that there would be a large number of people at the party and while much of the organization is getting up in years there would be a number of younger and stronger folks.

So I took the problem to my physical therapist and asked how a wheelchair could be moved up a flight of stairs. I had originally thought that I would have to be taken out of the chair and carried up the stairs ignominiously using a fireman's carry. The answer is much simpler and two women demonstrated how a chair could be tilted backwards and rolled up a flight of stairs. Bump, bump, bump. It turns out that while the chair is rolling the occupant can significantly aid the process by pulling on the wheels.

Getting down is essentially the same process except that the chair is rolled forward down the stairs while being tilted backwards. Getting up the staircase went very smoothly. We used four people to get up the stairs and only three to get down. I am convinced that two would have been completely adequate for getting both up and down.

In the future as long as there aren't a few strong and able bodied people around there is no need to tell our friends that we cannot go to their house. In the future the club will meet at the hosts house and with a little help I will get up the stairs and joined.

Falling Down

I have been in a wheelchair for over four months. During that time I have been in my chair, on the bed, in a love seat that we bought so I would have some place to sit that was not a wheelchair. We specifically raised the seat four inches to make transfers to and from the love seat. All the time I was deathly afraid of what would happen if I missed a transfer, leaned too far or otherwise messed and ended up on the floor.

I had talks with the physical therapists about what was to be done if I found myself on the floor. If it happens when I am alone, the answer is not pretty and may well involve a call to 911. With two people to help, the answer is a fireman’s carry back to the wheelchair. With only one helper, we reviewed a complex technique involving laying the back of the wheelchair in the floor. Carefully placing the body in the chair with the back down and then lifting the chair up. I was not at all sure I even remembered all the steps, let  alone had the strength and skill to do them.

Eventually it had to happen. I had just gotten on the love seat and was still on the edge when I tried to roll the wheelchair away so i could see the TV. I loosened   first the near brake and then leaned over to loosen the far brake. As I was leaning over the wheelchair slipped. Normally, with the brakes set, I would be able to catch myself on the wheelchair but with the brakes released I had no support and slipped slowly to the floor. Now I was on the floor and had to figure out how to get back up. Fortunately  a couple of weeks earlier we had bought a Hoyer lift.

Normally these lifts are not used by peoplewho have the ability to transfer themselves.They are used by people whose arms are weak enough that they are unable to transfer.I had an interesting problem I was trying to solve.I was trying to figure out a way to get from the wheelchair into the hot tub on my deck. The idea of the lift West transfer me from the chair into the top . It didn't work because in order to transfer you have to slide the legs under the hot tub. We thought that there was room but were wrong. Now the lift was sitting about 3 feet from where I fell while we tried to figure out what to do next.

The answer was very simple. Verna brought the lift over to me. She slung me in the sling, raise me up and placed me back in the wheelchair. It was that simple. However,had we not bought a piece of equipment that I really did not need, I would've been sitting in on the floor with a huge problem on my hands. Sometimes life just works out that way.

The Goldilocks Car

In the story of Goldilocks and the three bears, Goldilocks attempts to eat three bowls of porridge, one is too hot, one is too cold and one is just right. The metaphor has been used for many purposes – most recently in looking for earth-like planets that are  neither too cold and thus ice balls or too hot sustain life. In the context of this essay we are looking for cars that are just the right size, not too large and especially not to tall, not too short, not too large and especially not too small.

When you are in a wheelchair there are many limitations on the card you want to buy. First, the car must be of the right height to make it easy to move from the wheelchair into the driver seat. If the driver seat is too high, it will be very difficult to make this move. The same problem applies if the driver seat is too low, although very few cars fit into this category. Secondly, there must be enough room with the driver seat set as far as the reader as possible to allow the wheelchair to be disassembled and placed in the passenger seat. This process must happen any time a driver in a wheelchair asked to enter a car by himself and drive off.

There are other features which are nice to have. When there is a passenger, instead of disassembling the wheelchair and placing it in the passenger seat, the driver will ask the passenger to put the wheelchair somewhere in the back of the car. If there is a large enough space in the back that the passenger can put the wheelchair there with minimal disassembly, the situation is ideal.

The next thing we considered was the possibility that at some time we would want carry more than two people in one of our cars. My wife drives a Honda Civic which lacks room to take the wheelchair in the trunk. This means that when I am a passenger in her car most of the backseat is occupied by the wheelchair and a third passenger may be accommodated only with great difficulty. Ideally, if there are four passengers it would be nice if the wheelchair were completely outside of the passenger compartment. It might live in the trunk if there were sufficient space or if the car were a hatchback or had other space in the rear the wheelchair could be disassembled and placed in that space.

We went four car dealers and looked at various cars. Most cars were either too high or had other reasons not to be considered. So far the car that we like the most is the Honda Fit. The car is low enough and has enough space to place the wheelchair in a back area without disassembly. We have not gone back and tested to see if there is enough space when the rear seats raised to allow the wheelchair be placed in the back area.

Within the next week or so we will look at other cars, things like the Toyota Scion and maybe be PT cruiser for other candidates for a car we might buy. In the meantime I am taking training in driving cars with hand controls. I did this once before when I was in a cast and rented a car with such controls but I suspect the permanently installed controls may be more serious and perhaps easy to use.

The Line

I woke up and I knew immediately that the line had gone bad. My arm was not a swollen mess of spilled antibiotic, it merely felt a little painful in the little wrong. It was a month after my accident and several days after surgery to correct an infection in the original wound. I was on the surgical floor on Memorial Day weekend, the surgery having taken place late on Friday. I had to have infusions of two antibiotics several times every day.

Immediately after the surgery it was known that I would be taking antibiotics for a long time. I ended up taking the intravenous antibiotics for almost 6 weeks. It was also well known to the surgery team that when a patient needs to take antibiotics for that long the proper approach is to put in a central line called a PICC line. This line is placed into a deep vein and ends up relatively near the heart. These lines can last for months with relatively minor care and almost never go bad. There was one small problem, this was Labor Day weekend and it would be four days before the team that placed a PICC line would be available.

So for four days I had to receive numerous infusions in lines that were stuck in my peripheral veins. The problem was that these peripheral infusions never lasted very long. I had no needle in a vein which could remain viable for longer than a day and a significant number lasted a much shorter period of time. This raised another problem, finding the best expert to try and insert a new line.

There is a general rule that when you want something done and this can be almost anything the best thing to do is to find somebody who does it every day many times each day and choose them. These people will always do a better job than others who like The task only rarely. Thus, if you want somebody to draw a blood sample from you, the best person to ask is a phlebotomist who does nothing else all day but draw blood samples.

I rapidly discovered that bedside nurses were not particularly experienced at placing intravenous lines. I had a particularly bad experience one night when two nurses took three tries to place an intravenous line and almost failed on the third time about the time I was willing to send them away and take my chances on anyone else.

As my lines started going bad, I tried to learn the best nurses for placing new lines. There was one angel, and Ethiopian nurse called Heba who had a particular skill and whenever she was on duty I insisted that she be the one to replace my line. When this was not possible I asked for the best expert that the nurses had. He came in, he tried, and he failed and after that he went off to look for an even better expert.

I believe that during the four days between my surgery and the time that the central line was finally inserted I had at least five the intravenous lines put in at a cost of significant pain and trouble.

Once the central line was installed, it worked perfectly and both the nurses and I, since once I went home I was placed in charge of infusing my own drugs. The line lasted six weeks and was removed only when for other reasons I was placed on oral antibiotic. Okay

It is Written

I met Rick and Robin at a class on spinal injuries. While I was easily the healthiest person in the class in a manual wheelchair that I could control by myself, Rick was easily the most seriously injured. He was in what is called a puff and sip wheelchair, a complex motorized system that can be controlled by blowing or sucking on a straw inserted into the mouth. Accompanying him at all times was his wife, Robin, a lovely lady in her 60s.

We got to talking about Rick's accident. It seems that he was playing catcher on a softball team in Green Lake. The league rules prohibited bodily contact although they did allow runners to slide into base. Robin keep shaking her head and saying that Rick did not want to go to that softball game. He had other things to do that day and the decision to play was a last-minute one.

Because Rick had a shoulder injury, the team decided to let him catch. So he was at home plate when a young kid decided to round third and make a very risky run for home. Rick had the ball and was prepared to tag the kid out when he slid into home plate. Instead of sliding, the kid all the rules and ran straight into Rick. The impact both broke and twisted Rick’s  neck. Lying on the ground at home plate, he knew he could not feel his legs but had some movement in his arms.

By the time he was taken to the hospital and stabilized, most of the arm movement was gone. Currently he has little or no control of his arms which is why he is required to use a puff and sip wheelchair, the only type suitable for people whose injuries prevent them from using any kind of hand control.

With significant luck, he might be able to gain sufficient use of his arms to enable him to feed himself and maybe perform a few other operations. Needless to say, he is very depressed as I would be if I had similar injuries.

Robin keep saying "it must have been written". There is little else that she can say. All I can say is that I am truly glad that Rick has a devoted and dedicated wife like Robin to help him through this troubled time.

Dueling Flora and Fauna

The role of normal intestinal bacteria is frequently downplayed or ignored. Normally the intestines are colonized with an array of normal and friendly bacteria within a few days of birth and these bacteria continue to grow and help the intestines function throughout a person's life. Normally human feces contains about a third by weight of E. coli which is a normal constituent of the intestinal flora. While it is true that some strains of E. coli can cause very serious illnesses, the fact that E. coli are always present in human stool and that without E. coli the guts would not function well is a fact that is frequently neglected.

All of which brings me back to my bowel program. A major objective in spinal injury cases is to regularize the functions of the bowels so that you elimination can be handled once a day at some convenient time. I have been having nothing but problems with this program and it is my greatest worry about going home that bind bowels will not be regular and functioning properly.

At the same time I have been on regular antibiotics for over three weeks to deal with an infection in my wound. The fact that was lost on me for a long time is that no matter how hard the antibiotics are on the infectious bacteria that we are trying to kill, they are also hard on the normal bacteria on which I depend for my daughter did not function in a normal manner.

On top of this there is a bacterium which is fairly common in the hospital which is notorious for colonizing intestines where the normal bacteria had been decimated by antibiotics.Clostridium difficile  or C dif is a standard problem in hospitals and when it infects your gut it can raise havoc with any concept of regularity.

Last night I was diagnosed with C diff. Immediately the nurses arranged to move me to a private room and not just any private room but a private room with a large warning sign on the door telling all personnel that I am infectious and that special precautions including gowns are required when visiting my room. In effect, I have been treated a little like a plague bacillus.

The rules, however, are much stranger than that. The infection should not interfere with my therapy so that it turns out that when I leave the room as opposed to someone entering it there are no special precautions required. I have normal access to the floor and can even go down to the public hospital cafeteria to get my dinners. The world is very strange.

I am now on antibiotics to deal with this new invasion of my body. It is not serious or life-threatening but it is annoying. Furthermore I have three more weeks of antibiotics to go to do with my original infection and as long as I am taking these antibiotics I can never be sure that the flora and fauna in my gut will be stable enough for me to establish a regular routine.

The Suffering of Rich

Many of the stories that you see in the rehab wards will bring tears to your eyes. The story of Rich moved me in special ways. I was sent to talk to him because I had tested the power assist set of wheels were my wheelchair. I found them useful but probably not worth the cost since I would only use them for a few instances. One of the therapists told me that there was a patient who had a pair of power wheels he was willing to sell. A few days later I looked him up and discovered that not only was he selling the power wheels but an entire second wheelchair. At this point the offer was too good to refuse and so I went to talk to him.

He was a nice man, neat and well composed in a newer power wheelchair. He explained that he had lost strength in his left side and was no longer able to manage a manual wheelchair. As the conversation progressed it was clear that the problem was much more serious. Rich was a patient with multiple sclerosis and had begun using a wheelchair as his peripheral nerves slowly failed. However, about two months ago a terrible thing happened. He was in his driveway using a gas powered leaf blower when the device exploded showering him with burning gasoline. He is alive today only because his wife heard the explosion or perhaps his screams and quickly doused the fire by covering him with a blanket. Even so he had severe burns over much of his body. I could see the scars on his arms but his legs, he showed me, were much much worse and were nothing more than scar tissue over most of the surface.

He has been in the hospital for about sixty days since the accident almost all of that time being spent in the ICU and the burn wards. Only within the past week or two has he been considered well enough to come to the rehabilitation Ward and work on adjusting to returning to the world.

I can only imagine what he must have suffered during those months in the burn ward. He told me stories about stapling a dressing to his legs and how as the legs healed they had to pull all of the staples from his legs.

Having to live with a diagnosis and the steady progression of multiple sclerosis is bad enough but to have to deal with a major burn on top of it is more than a human should be asked to endure.

Still as I chat with him I am impressed with his cheer, his determination and his will. Rich is not a man to let misfortune drive him down. He as almost bubbling with enthusiasm and a drive to enjoy life no matter what it may throw at him.

Marco’s Half Tale

You meet some strange people at Harborview know my brief encounter with Marcos  in the rehab floor one room was one of the strangest encounters I have had in this place. Marcos was a grizzled Oriental, possibly Filipino who was sitting in lunch room holding a walker which he pretty obviously did not need. He explained that he had been in rehab but had been out for a while and was now back to complete an errand. He then explained that he had been in a wheelchair and while in the wheelchair had suffered a hard time in some unspecified manner. Now he said "it's payback time". I must say I was startled and somewhat appalled at a man who had recently been in a wheelchair wanting to attack his tormentors, whoever they might be.

He then explained that he had been a Blackwell pilot in Iraq and that he had modified his helicopter to allow it to carry more wounded soldiers. I asked how many and he said that the helicopter could carry seventeen wounded. I then asked if his injury had to do with a helicopter crash. He said no, he had the and in a bunker and the bunker a few rows down had been hit with a SCUD missile and during the attack he had inhaled cyanide gas. I found this story fairly fantastical and gave it relatively little credence.

His mission in rehab was to turn in the walker in exchange for a cane. The therapist explained that wants a piece of equipment was issued to a patient it could not be returned. When he asked what will I do with it she suggested that he donated to Goodwill. He then wondered whether Goodwill would be willing to trade a walker for a cane. I expressed grave doubts but suggested that canes had Goodwill were very cheap.

Marco’s response was to say "where will I get money? Will I have to jack a car?".

At some point of I asked why the Veterans Administration was not taking care of his case since he was clearly an Iraq veteran with a service related injury. He shook his head and said "the VA doesn't want anything to do with me"

I have no idea what the real story is in the end of this tale is that after he left the lunchroom I talked to one of the aides who had been dealing with them and said "I’ll bet that is a very interesting story that you are not allowed to tell me"

A Degree in Computer Science

I find myself amazed and perhaps a little bit scared at the idea that the two of my roommates held degrees in science. Both Tom and Savior Tony say that they hold a degree in computer science. Tom's degree is especially sad. He was sold a program for you eleven thousand dollars to give him a degree in computer science and robotics from a private university in Arizona. Tom is a fine individual but in no way would I trust him with a serious problem involving computers. I have never seen him use a container and I doubt very much that he had significant familiarity with computers when he entered the program to be able to gain anything from the materials that they were teaching him.

I can say less about Savior Tony. He says and I believe him that he set up a computer lab in the the center to allow neighborhood children to be able to use computers. It is entirely possible that Tony could do this and even that his degree may have aided him although I must confess to a certain degree of skepticism.

It is a terrible thing when our poorest people are being sold training largely characterized by the latest buzzwords. I do know that both Tom and Tony are good people and that I would never, ever consider them for any job relating to computers.

Freedom

Initially you lie in bed that is more you can do with your broken body and your useless legs. All  you or you do is lying in bed. The first relief, that is offered is is a wheelchair. Initially it takes a nurse and and aide to move you from your bed to the wheelchair. Eventually you learn the skills to make the transfer on your own. The ability to get into a wheelchair gives you the freedom of the hospital floor. You go many places and do many things that you cannot do lying in bed but in the end you are still held in a larger cage.

Weeks later, as your abilities improve, and much more valuable transfer becomes possible. The day that you transfer from a wheelchair to a car is the day that you can leave the hospital and enter the world of at large. Until the day that I successfully demonstrated the ability to transfer into her passenger seat she was convinced that her Honda Civic was too small or too what ever to allow me the ability to make this transfer.

The moment I could successfully move from a wheelchair to a car, I had the freedom of the city as long as I could enlist the aid of the willing driver.

The next freedom will come when we buy a car equipped with hand controls and acquire enough skill and confidence to be able to move alone from my chair to the car and to be able to disassemble and store the chair before I drive off. At that point I will have achieved full freedom.

Shelly and Tony

One evening as Verna and I were returning from dinner, Tony called us over to his side of the room saying “I want you to meet a wonderful lady. If it wasn’t for her I wouldn’t be alive today.”

Sitting next to his bed was a petite, white woman, about 30 with her hair entirely concealed in a net. “This is Shelly” Tony said and we all shook hands.

Shelly started to describe the incident where Tony’s heart stopped. “He was wild, running down the street screaming and yelling and I knew that I had to go out and help him, even if I was not sure what I could do.” Shelly cannot weigh more than half of what Tony weighs. Here she is in her house throwing on a few clothes to rush into the street to deal with a wild, mad, black giant. As Shelly approached Tony he went into seizures and later cardiac arrest.

Fortunately, a passing woman saw it all and called 911. Again fortunately a police car was very close and immediately cam to help. I can only presume that while Tony’s heart was stopped for 20 minutes, most of the time someone with CPR training was pounding on his chest.

After that we had a long discussion on the negative ions that come off of screens and how the pink Himalayan salt can absorb and  the negative energy. How energy flows affect your life etc.

It is clear that there is a strong bond between Shelly and Tony to the point that when Tony is released, Shelly is the one who picks him up.

Savior Tony

I saw a small army move my new roommate in but I really didn't get a chance to talk to him until they all left. He was standing by my bed. He was tall, black and he had long dreadlocks. Of these the most unusual statement was that he was standing and standing tall and straight and strong which is very unusual for a rehabilitation ward.

He began to talk and for the most part I merely sat there and played psychiatrist asking questions and listening to his story. It seems that a couple of weeks ago his heart stopped for over twenty minutes before they were able revive him. He says he is very lucky to be in the right place at the right time where there were people who could help him. I asked about drugs which would be an obvious cause for cardiac arrest but he denied using drugs.

He says his name is Savior Tony. The last part was given by his parents and the first part he chose , presumably after a religious conversion. He said he wanted his name to be that of someone he really admired.

Tony says that he has done many things that are wrong and many things that are violent. He has been in prison but says he does not remember why he was sent there.

You cannot have your heart stop for twenty minutes without suffering many losses. Tony was an excellent chess player and has set up a clinic to teach chess to the local youth. Now he is not even sure he can remember the moves on a chess board.

 

Tony is from New York and has spent most of his life living in Harlem. He has become a appalled at the way Harlem is being gentrified and the blacks who have lived there all their lives are being forced out. Recently he came to Seattle flight the same gentrification in the central district.

Paul

My room mate is Paul. Paul is a chef and a consultant on restaurant design and management. He has suffered a stroke which affects his left side but not, thank God, higher-level functions. Using the rehab unit to receive therapy is in training to deal with his disabilities. Paul can walk with the aid of a walker but about half the time he uses a wheelchair.

Paul has been estranged from his family after a very ugly divorce. The most ugly incident involved a court hearing about the fate of his children. Paul went to the wrong courtroom and because he did not show up he lost custody of his two boys. He has a good relationship with his niece and nephew on after that hearing he ran away and never tried to contact his boys again. One of the goals I set for his hospital stay was to have him call his oldest boy who is grown, married and living in Las Vegas. I failed, he never managed to find the kid’s number but he did promise to make the call.

One night, practicing his cooking skills, Paul may pasta with meat sauce for much of the rehab floor. We tried it and it was excellent. About two weeks into my stay Paul was sent home and I hope that his home, or perhaps that of his nephew has good enough facilities to keep him and nurture him during his recovery.

Sarah phones home

I was sitting in bed reading the New York Times on my laptop when Sarah walked in. Sure is a very nice woman who is a nurse's aide and also, I kind of knew this ,Ethiopian as are many of the aides in this hospital.

At some point on persuasion turned to computer can do, actually I remember she was pointing to the video camera that I had brought in to allow me to make video calls to my friend's and I was discussing how you would make a video call. Somehow the subject turned to Skype which is one of the ways that I use to make video calls.

 

Sarah wondered if she could use Skype to call her friend in Ethiopia and
that was very simple. I went to Google and looked up the country code for Ethiopia and then dial the number. The call didn't work the first time because I refuse to believe that a cell phone number would start with the numeric prefix 911. Especially on . With a little correction we immediately reached her friend and she was able to have a nice conversation to my laptop and to Skype’s output lines into the Ethiopian cell network.

During and following that conversation I learned two things, first of all Sept 11 New Year's Day in the Ethiopia and second that Sarah had been trying for much of the day to call her friend using a conventional international calling card and because it was New Year's Day had never been able to get through which, of course, had not prevented the card from consuming significant amounts of money.

Before I leave the hospital I will teach there out of such set up Skype and specifically the free calling feature which would enable her to talk to her sister's laptop backup.

The sidewalk jungle

Yesterday I went out with a team of recreational therapists. We took my wheelchair on the street and rolled about ten blocks lowering the local neighborhood. What I learned on this expedition is that sidewalks are nothing like the smooth halls you find in the hospital, or the office, or the home. Sidewalks have cracks. Sidewalks have bumps. Sidewalks are just rough enough to cause serious problems for a newbie wheelchair user. I spent much of my time scanning for the best path and figuring out which bumps I can simply roll over and which bumps I must carefully stop at to avoid the possibility that my wheelchair might tip or simply reach what I consider to be a dangerous position.

All of this will come with experience, much experience and the more I can get out in the neighborhood and learn what it is that I can and cannot do, the better off I will be.

What I have learned from all of this is that when accessibility is an issue the world looks like a very, very different blocks.

Pumping Iron

Fortunately my upper body strength has a spared and I have much the same upper body strength as I had before the accident. This is very good and means that I have enough strength to run my wheelchair and performed many operations of daily living. However, I have never been an athlete and certainly do not claim great muscles. As I move to a
where I am using my arms for everything that I do I will require much greater arm strength than I currently have.

Every day, on my own and with the aid of my therapists I am pumping iron. The therapists have a series of exercises designed to strengthen every muscle in my upper body and I am applying myself to these exercises with a vigor that I never applied myself before the accident.

I have never been very interested in sports and certainly never interested in raising my competitive level with bodybuilding. Now I am on a forced march and I carefully choose the maximum weights but I think I can handle. I know where my body is going with this and I may end up being surprised at what my body looks like at the end of this process.

On the other hand, one of my great frustrations is the inability to perform maneuvers that would be relatively simple for a six month old. Chief among the these is the ability to scoot my body in the bed either toward the head or to one side or the other. My therapist describes the way to do this which involves pushing back with your elbows, raising your body and slowly walking to the right position. Needless to say, I am not even close.

In horizontal orbit

The line is not original. It is the name of a book written by somebody who, like me, has spent a lot of time in a hospital. When you go to tests or x-rays or MRIs you are pushed on a gurney through the halls of the hospital and all you can see are the tiles of the ceiling going by.

 

I spent today in a kind of horizontal orbit waiting to be transferred back to the rehabilitation ward where I can resume my therapy. The process most of the day. We thought we were ready to go and then some silly nurse transcribed a discharge note which means that the note was recorded and sent to someone else to be typed. Naturally, we had to wait for the typing to be complete before the transfer could resume. At some time my wife had a melt down in front of the unit supervisor and with the sheer force of her personality was able to speed up the terminally slow process. By three o'clock in the afternoon I was finally back on the rehab wards ready to resume the therapy that will eventually get me out of this hospital but, this process cannot start until tomorrow.

The Question

pokers were slowly heating on a bed of coals. Pumping the bellows he said “you are an abomination who has chosen state and over God and before I am through with you you'll beg for the purification of the fire.” He chose an iron which had turned a fine shade of white. As he applied it to the heretics arm the man began to scream.

In the hospital, they ask you about pain and perhaps because it is required in some obscure federal mandate it is always the same question, on a scale from 1 to 10 where one is an inconsequential pain and ten is the worst pain you can imagine we are just your pain fall?

‘I have a very good imagination as the first paragraph, almost a scene from a book I was reading at the time, illustrates. The first time I was asked this question, I was recovering from spinal surgery and I answered that I thought I had about level V pain. Meanwhile Verna who understood the game was frantically signaling with her fingers that I had a level VIII. Level VII or eight turns out to be a good answer if you want medication for your pain.

I have been asked this question a large number of times in the past few weeks and created as a binary question answers like 7, 8 and nine indicate that I want pain medication and any other answer says that I am really okay. I have no idea why people in hospitals need to play this silly game.

http://www.xkcd.com/883/

Bombakar

In the hospital you work with many aides. I have made a conscious effort to learn the names of all the nurses, the students, and the aides who work with me. There was one in aide who came to me in the night. He was black and closed in on himself silent almost to the point of unresponsiveness. Frequently he failed to understand what I was asking and in the end I thought that he was a little slow and let it go.

When the nurse came by I decided for the first time to request a different aide to handle my case. It was a bit of a painful decision and may have been colored by the fact that I did not know the man's name. As it turns out, it was my fault I had failed to ask.

 

A few days later, he returned to assist my nurse with a transfer. This time, I did not fail to ask his name. His face brightened into the biggest grin that I have ever seen and he said that his name was Bombakar. . Naturally, I asked where he was from. He replied that he was from a country that I had never heard of called Mali. He was wrong. Not only have I heard of Mali, but my brother-in-law served with US AID in his country for many years. I have always regretted not finding the time and the money to visit Larry while he was in Mali.

I learned an important lesson in humility that day and if I see Bombakar again I will tell him that the greatest gift you can give to this ward is his joy at his smile

The transfer

It is the first skill I will need. I am in bed next to my bed is a wheelchair. Sitting on the seat of the wheelchair is a small board may be 8" x 24". My job is simple I need to get my feet off of the bed. Raise my body to a sitting position. Place the board so that one end is on the wheelchair and the other is under my behind. Next, I need to move my body on my arms and slide several lifts from the bed to the chair. Finally, I need to remove a board and lifting my body with my arms positioned myself in the wheelchair.

 

It sounds very simple. It is the first thing I will need to master. After that, I will need to learn much the same move from the chair to a car seat. Of course, for every transfer there is a transfer in the other direction.

 

If I master this move I have gained a measure of independence.

 

If I master the transfer and the car transfer and a couple of other skills then I can go home. Going home is not the end of my therapy for the end of my learning what it is a big step and one that I dearly want to achieve.

Tom

After after they cleaned my wound I found myself stuck on a surgical floor. I was stuck because the operation was on a Friday on a long holiday weekend. I was stuck because Harborview earns more money when I am in a surgical floor and then when I am on a rehabilitation floor.

 

So here I am on a long Labor Day weekend stuck in the wrong bed, on the wrong floor, in the wrong unit trying to make the best of it. My roommate is Tom. Tom's body is broken and misshapen. He can walk but with each step I feel your pain. Only by comparison is Tom able bodied. I am in no position to be picky and will take any able-bodied help I can get.

 

After a while, Tom told me his story. One day about a year ago, Tom was set with his girlfriend and disgusted with his life. He drove his truck at 100 miles an hour into a concrete pier on the Ballard Bridge in an effort to end his life. He failed. The state pulled him from the wreckage and sent him to Harborview where at a cost approaching a million dollars they restored his body to some semblance of normalcy and eventually discharged him to a nursing home.

 

He has many stories up a nursing home and his life on state disability. He was living on an amount of money that I would consider to be a joke. Now he is back in the hospital trying to restore movement to his arm so that he can touch his head and help to Kate take care of himself.

 

Tom is quiet and nice and very helpful. He is a great roommate and I only wish that there are things that I could do to make his life better. Before he leaves I give him an old laptop that I had in the garage set up to do a few things which might simplify his life. I show him how to get e-mail and how to place ads on craigslist so that he can look for work.

 

Tom earns money cutting lawns and doing other kinds of unskilled manual labor. It would give me pain just to hire him and see him use his twisted body to perform some task I am unwilling, or now unable, to perform.

 

I have heard my wife tells stories of taking care of failed suicides. She tells me of a man with little left of his jaw and his face after an attempt to shoot himself in the head failed.

I must wonder whether if our society cannot give these people help perhaps they can give them a way which is painless, clean, and sure. And in doing this are we performing a great sin.

. Tom, where ever you are wish you a great life.

I Fell

.

I had too much pride. I was proud of my skill. I was proud of my plane and like Icarus might overreached. I looked at a state airport, a rarely used dirt strip in the woods near Lake Wenatchee. I ignored the voices of caution telling me that this was not easy.

I knew the moment the plane was airborne but I wanted to abort the takeoff and I knew the runway was too short. I was in a corridor no place to turn and no hope but to out climb trees. I almost succeeded. Another 10 feet and I would've been free and in the air. But that was not to be.

I remember hitting the trees.

I do not believe in God. I cannot give another credit or blame for what happened next. Somewhere a dice was thrown and my fate and that of my passenger were in the hands of the universe.

 

I died my broken body and that of my passenger were removed from the plane and taken to the local more. This might have happened. Perhaps it was the highest odds on the dice but it did not happen.

The dice spun and when they came up I had my life. I had my mind. I had my arms. I could not feel my legs. My passenger was in even better shape and while there are injuries she will ultimately regain almost everything. One day she will dance and through her I will move in ways that may never be able to do.

 

Like a Icarus I have been hurled down by my pride and I lie in a hospital bed rebuilding my life.

 

The first lesson I learned is humility. I have sinned the sin of pride and not just in the air. I I have committed the sin of hubris in other ways. Many people, the waitresses, many of my students and others have been allowed to drift in and out of my life as shadows unknown, unnoticed and anonymous.

The lesson I learn lying in my hospital bed is there are no anonymous people. Everyone who comes to me every nurse, every aide, every student has a name and a face and the story. They are part of my life and no longer unnamed and unnoticed. In this is the great lesson I learned when I fell. You have no pride. You are one player in a great drama that flows around to a new universe for its own reasons has allowed you to continue to play.