Page Utilities
Glenys Carl, Pan Books (page 2 of 13) Page 2 of 13
In the ensuing days I redouble my efforts to further his rehabilitation. I read to him longer, and with a firmer voice, believing that even while he sleeps my words are stimulating his brain. With renewed vitality I massage his hands and fingers, slowly and gently move his good right arm, and manipulate his feet to stretch the Achilles tendon. But I sense I am walking a thin line. Too much stimulation might be more dangerous than too little. Overloaded, Scott's brain might shut down to seek refuge in the protective tranquillity of his coma. How much is too much? Where is the trigger? How will I know? Don't ask questions, my inner voice instructs; trust your feelings, trust what Scotty tells you. As if responding to my determination, his body responds. Each day he stays awake a little longer. He flexes his fingers a little more, and with my gentle help, he moves his good arm and his head slightly.
At the end of that week, a steel tilt table is wheeled through the door. After months on his back, Scott's heart, organs and muscles need introduction to the stress of vertical living. Reborn into his new life, like a baby, he will need to relearn the most elemental of skills. From across the room, I watch the orderlies carefully lift Scott from his bed to the brown cushion of the tilt table where his body and each limb are carefully strapped into place. A physically fit patient would assist in his own transfer by stiffening his muscles, but Scott's muscles are shrunken, making the short lift from one bed to another a delicate manoeuvre.
At first the tilt table is raised only a few degrees for one to two minutes, while a technician checks his pulse and carefully monitors the colour of his face. If Scott's face turned ashen, a sign the heart was overworked and blood was pouring to his feet, the table would be lowered immediately. But his pulse remains strong and his face looks healthy. The table arrives daily, and gradually over the next five weeks the incline is increased: five degrees, ten, fifteen, then forty-five, while the length of time is also increased from one minute to five, then to ten, fifteen and up to thirty.
But as the table slope increases, gravity weighs in with its own consequences. The tracheotomy tube still inserted in Scott's throat takes on a new weight as its angle changes slightly, and sometimes causes pain at the incision. Arm and leg muscles, long accustomed to the horizontal support of the bed, find themselves hanging vertically with an unaccustomed weight that strains their attachments to the bones. Internal organs that had found a new nest within Scott's horizontal body are now being stretched from their comfort and forced to reposition themselves normally. Yet through all the pain, barely a moan escapes his lips.
Suddenly I feel weak and insignificant. Could I be unworthy as a mother? My own self-indulgence, suffering, my weeks of self-pity, loneliness and guilt pale next to Scott's struggle. Who is being healed here, and who is the healer? Rather than my nurturing him, Scott inspires me. He gives me the spiritual and emotional strength to carry on, to be a better person.
In the second week of the tilt table therapy, a speech therapist appears, pushing a small white cart on wheels. 'I'm here for Scott's swallow test,' she announces with a cheery smile. 'We've been feeding him by tube, and now we have to see if he can feed himself,' she adds, as she jockeys the cart closer to the bed. 'People in a coma forget how to eat; their swallow muscles get lazy. So what we're going to do now is see if these muscles still work.'
From a bottle she pours a few drops of dark liquid into a spoon, and supporting Scott's head with her left hand, slips the tip of the spoon into his mouth to see what might happen. The muscles in his throat constrict as he swallows the drops. 'That's very good, a good first step,' she says, as if Scott were an average patient with an average broken neck. 'It seems you haven't forgotten everything. Now how about we try some jelly, something nice and soft.' With a spoon she places a small amount of jelly into his mouth. Again Scott's throat muscles ripple as he swallows. 'Swallowing is more difficult than you think,' she says, while closely observing Scott's responses.
I am deeply amused by her unusual chattiness. Perhaps like so many others who daily enter our room, she has been inspired by Scott's struggle and miraculous recovery.
'We take swallowing for granted, don't we?' she bubbles on, 'but when you have forgotten how to swallow, you have also forgotten so many other things, like coordinating your tongue and breathing with swallowing. Of course this is unconscious. It's really a brain problem, you see. If Scott tried to swallow this jelly at the same time as inhaling, he might suck food into his lungs. So his brain has to sort it out, to relearn its old habits.'
She spoons another small helping of jelly into Scott's mouth, which he handles fine. 'He's doing so well, Glenys. We'll do this for a few more days. If he passes with good marks, we can probably remove the tube.' Gathering her equipment, she wheels the cart from the room.
I feel an immense sense of relief and accomplishment. Another small step. No, not a small step, a big, big step, a more-thanmonumental step towards life. Slowly my fears are being tamed. I know now he can eat, but can he speak? I won't know the answer until the tracheotomy tube is removed. In the meantime I will work on Scott's language comprehension.
Next morning, I find a large piece of cardboard, about two by three feet, and with a black marker write words in large letters across it: red black hot cold sleepy music yes no.
I prop up Scott's body with pillows and sit on the side of his bed holding the sign about two feet in front of his eyes. 'Now then, Scott, I will say a word and I want you to point to it. Just point with your eyes. I'll know what you mean. Do you understand?' I search his brown eyes for an answer. They are looking at the board, but reveal little understanding.
'Good.' I continue the game. 'Now find the word “hot”.' Scott continues staring at the board, then slowly his eyes begin a crawling search until several moments later they focus on the word 'hot'. I breathe a deep sigh before continuing. We work through my list of words. My confidence grows that his brain is capable of processing abstractions. I also notice that as his eyes search, he is trying to move his arm, as if driven by a compulsion to point.
From Hold My Hand: A Mother's Journey by Glenys Carl. Pan Books, Pan Macmillan LTD, England, 2005. All rights reserved.
