Here is Chapter 7 of Dreaming Out Loud, the book about my mother’s stroke.

Chapter 7

Paula and I journey home for the night along cold, empty streets. I see a blur of traffic lights, darkened office signs, solitary trees. Their leafless branches seem as fragile as blood vessels. Our thoughts are heavy, and we do not speak.

As we unlock the door leading from the garage to the hallway, we are greeted by a duo of happy dogs, Daisy and Hortense. Needy cats bellow incessantly. After feeding the beasts and dishing out the last ounces from our treasure trove of affection, we kick off our shoes and clothes, lie down on the bed, and turn off the lights. The house is dark; all is silent save for a few creaking boards and the occasional hissing of territorial cats.

I have never felt more exhausted and yet more fully awake. No matter what I do, I cannot shut off my mind.

The kitchen clock ticks with methodical precision. The fan beside my bed slowly whispers in my ear as it oscillates. Time meanders, hours pass, and still I do not sleep.

The darkness slowly disappears as daylight creeps through the window. Paula remains a dark lump burrowed beneath the bedcovers. Her breathing is gentle and rhythmic, but I do not know if she is asleep.

The telephone erupts shortly after 7:00 a.m. It is December 30.

I pick up quickly so the sound will not disturb Paula.

“Hi, Mike. Did I wake you?”

“I wasn’t asleep.”

Polly is on the line, and I learn that my relatives had been gearing up for the coming travails. Despite the lateness of the hour, family members have talked with each other; conference calls have been arranged and e-mails exchanged; decisions have been made. My input is neither solicited nor desired. In one sense, this lack of input relieves me from making decisions at a time when I am unable to make them. In another sense, though, it relegates me to a supporting part in an unfolding drama in which, like it or not, I initially assumed a starring role.

“We’ve booked our flights for next week — unless you need us to come sooner. Tell me if we should come today.”

“Next week is fine.”

“Are you sure?”

“Yes. Next week works fine.”

“Can you or Paula pick us up or should we rent a car?”

I do not argue. If Polly’s sister is confined to the hospital and her chances of a full recovery are slim, the materfamilias will be on hand. Great generals know that battles are fought and won by becoming familiar with the terrain. Armchair warriors seldom win because they are far removed from the scene.

“We can pick you up.” Even as I speak, I feel a wave of exhaustion wash over me.

“Can we bring anything? We can get night gowns for Laura. Does she need pajamas? Are there any books or magazines that are her favorites?”

“I don’t know.” I cannot think of any material things that would improve the situation. “I guess we’ll have to play it by ear.”

“All right then.” Polly apparently senses my exhaustion. “We’ll see you next week. Call if you need anything before then.”

“Thanks, Polly. I will.”

It has been a long night. My world has altered in ways I can only dimly imagine. I am a grownup with all the trappings of adulthood — a job, a house, a car, adult responsibilities, and so forth — but in many ways I have prolonged my childhood. The pop psychology books refer to it as a “latency boy.” I have never liked the term; it smacks of arrested development, pampered children, immaturity. Perhaps it is accurate; I cannot say.

At 8:00 a.m., I call my boss, Anne, and tell her I need time to handle this new crisis. She is supportive and understanding, making all the right noises and offering me time off without questions. I am grateful for her kindness.

Without disturbing Paula, I slip out of the house. This abrupt departure may cause problems since she left her car in the hospital’s overnight parking lot to ride home with me the preceding evening. I am not worried. A friend can transport her later in the day.

Mom has been moved into a new room upstairs in the hospital. With no small trepidation, I creep into her room around 9:00 a.m. A TV bolted to the wall blares out an advertisement for carpet. The announcer confesses that the proprietor of the store undoubtedly is suffering from mental illness; no other conclusion can adequately explain his decision to slash prices with so little regard for profit. I find the mute button on the remote control pinned to a pillow next to mom’s head and mute the sound.

She sleeps peacefully. Her breathing sounds more labored than I would like, but at least she is still alive. She seems comfortable. Sliding into a green fold-out chair next to the bed, I count the number of wires and tubes extending from unfamiliar machines and IV bags into mom’s arm and various orifices. I am not sure what each of the wires and tubes is designed to accomplish, or to prevent, but they are impressive. We are getting our money’s worth, I guess.

It reminds me of a line from a movie starring the British comedy troupe Monty Python. Several doctors standing in a hospital decide to retrieve an expensive piece of medical equipment because the hospital administrator might come by to check on them. “Let’s get the machine that goes ‘ping,’” a pseudo-doctor suggests.

Rubbing my eyes, I push the chair back and recline. It is not a comfortable position, but I am tired. I slide into a fitful, uneasy sleep.

“Knock, knock,” a voice whispers after a length of time I cannot fathom. I look up to see a woman of indeterminate age standing in the doorway.

“Yes?”

She is not wearing a white coat or scrubs, so I quickly discern that she is not a medical professional. I have always been sharp as a tack.

Stepping into the room, she sends me a tentative smile. “I hope I’m not intruding. I stopped in to see Ms. Martinez. My name is Verna Springs.”

The name does not ring a bell, so I nod as I sit up in my chair and smooth the wrinkles from my shirt.

Ms. Springs sees the lack of recognition in my face along with weariness. Holding out a folder, she speaks in a soothing tone of voice. “I am from the Joan Glancy Rehabilitation Center in Duluth.” Duluth is a few towns away from the hospital. I have been known to shop in Duluth’s discount retail establishments.

Instinctively, I reach out and accept the folder from her hand. I probably would have taken a live hand grenade if one had been offered.

The cover of the folder shows several attractive white buildings nestled in the middle of numerous lush trees surrounded by vegetation bursting open with red and white flowers. It could be a well-respected liberal arts college if the buildings were larger. Whatever the place is, it does not lack for competent gardeners.

“You may have heard of us.” Ms. Springs speaks with no genuine conviction. How many people have heard of a rehab center until they need one? “We offer some of the finest acute care rehabilitation facilities in the metro area.”

Nodding, I open the folder and peruse the glossy pages. It is a thoroughly professional job, impressive in form and content. I pause to read about the doctors and staff of the rehab center. They have a long list of acronyms and abbreviations trailing their names.

Ms. Springs obviously has had experience dealing with befuddled and bereaved family members. Her voice is so soft it is barely audible, a few decibels above a whisper. “I know this is a difficult time. I won’t keep you. Look over the information and let me know what you think. My business card is inside the folder.”

“Thank you. I will.”

She disappears as quickly as she arrived.

That is how Paula, my soon-to-be stepdaughter Shelby, and I come to tour the Joan Glancy Rehabilitation Center the following morning, the last day of the year. I hate to leave the hospital, but mom has slept peacefully for 24 hours. She shows no signs of awakening, although the doctors assure us she is not in a coma.

The center is immaculate, exactly as it appears in the brochure. The grounds are cared for lovingly, the staff smiling and attentive, the machinery new and shining. A portly middle-aged nurse leads us through the exercise room, the cafeteria, and a vacant patient room, listing the benefits of the facility and the staff training.

“This is where I plan to come when I have my stroke.” It is her version of the used car salesman’s credo, “I drive a jalopy just like this myself.” The remark is supposed to make me feel better, but it does not. It causes me to wonder if I will suffer a stroke one day.

As usual, Paula asks all the right questions. She is the medical professional and speaks the lingo flawlessly. Shelby and I trail along behind her sheepishly, glancing at the posters and nodding our heads when questions or comments come our way.

I cannot help but notice the residents as we pass them in the hallway. Their sad, desperate eyes burn into me from their hollow, bony bodies. Most of them seem old — far older than my mother. Without exception, I do not see anybody who appears to be less than 80 years old, although looks can be deceiving.

Like my mother, many residents have suffered strokes and are temporarily visiting Joan Glancy while facing a fork in the road. One path leads to recovery, limited though it may be. The other path leads to death. I cannot say which path they will follow any more than I know which path my mother will follow.

Joan Glancy, we learn, prides itself on being an aggressive facility. Some rehabilitation clinics are designed for people who have reached the end of the road and cannot hope to experience anything close to a full recovery. Because the extent of recovery from a stroke depends in no small measure on how soon a patient begins rehabilitation and how rigorous the program is, different facilities subscribe to different therapeutic philosophies. Our hostess repeatedly assures us that this is an aggressive facility renowned for pushing stroke survivors to get on their feet as soon as possible. I like that practice. Be proactive; take control; strive for maximum recovery.

“What happens if a patient can’t — or won’t — be aggressive?” Paula is always the pragmatist.

The nurse stops and looks up at a stain on the ceiling panel. It is as though she has never considered the question before. “I suppose they can transfer to a less intensive facility.”

We continue our rounds.

A few minutes later, we pause at the nurse’s station, the end of our tour at hand. “So, do you think your mother will be coming here?”

Paula and I exchange glances. We like what we have seen. In a perfect world, we might explore alternatives on the internet, searching for testimonials from other stroke patients and their caregivers. We might compare prices. This is not a perfect world.

For once, I take the lead. “Yes, my mom will come here.”

“Well, good. That’s a very wise decision. I’ll tell Ms. Springs to give you a call and set up the transfer when your mother is ready to go.”

On the way home, we stop at the hospital to visit with mom. She is asleep and alone when we arrive. Her glasses are askew on her face, so I slip them off her nose and set them on the nightstand within easy reach. Looming over her bed, I notice that her mouth is open, drooping to one side, and she snores like someone who has not slept in a week.

A fruit basket and bouquets of flowers sit on the shelf that runs along the side of the room.

Paula kneels down to read the cards. “They’re lovely.”

Shelby inventories the presents. “Nana sure has lots of friends.”

Paula nods. “Yes, she does. Now let’s get her suitcase and pack up all this stuff. I bet she can be transferred as early as tomorrow.”

“How do you know?”

“Once she stabilizes, the hospital will need her bed for someone else.”

Paula is correct. Mom is transferred the next day. Someone, perhaps Ms. Springs, arranges for an ambulance to move her from the hospital to the rehabilitation unit. It happens early in the afternoon. They slide her hefty frame onto a gurney and wheel her out the front doors. Mom is awake and more or less lucid when she leaves the hospital, and I regret my absence. She leaves the hospital while I am in transit.

I arrive in her new room in the rehabilitation center within a few minutes of her arrival. “Hi, mom. Happy New Year! How do you like the new digs?”

She looks up at me, a bit confused at first, but then I see a flicker of recognition light up her face. She says something, but her voice is so soft I cannot make it out.

“Do you know where you are?”

She swings her head in a circle, taking in the room. I hope she will respond, but she merely looks back at me with a blank stare.

“You’re in a rehabilitation center. You suffered a stroke, and you are here to begin your recovery.”

As I speak, a large black woman adorned in bright blue scrubs marches into the room holding a tray of food in each hand. She brushes past us without acknowledging our presence.

“Good evening.” She speaks in an overly cheery, obnoxiously loud voice as she steps past the curtain. “Hello, Ida. I brought your dinner.” If Ida, recently disturbed from her slumbers, takes umbrage at this overly familiar greeting, I do not bear witness to it.

Mom frowns.

I jerk my thumb toward the curtain. “It’s not a private room. You have a roommate.”

“Laura.” The woman’s sweety-sweet voice already grates on my nerves. She steps around the curtain and sets the food tray on the table next to the bed. “Now, sugar, don’t think we forgot about you! We have a pureed diet for you. And we have apple juice. I bet you like apple juice!”

I smile. “Um, um. A pureed diet and apple juice.”

Mom frowns again. Clearly, I have lost my mind.

Ignoring my sarcasm, the woman inserts a straw into the plastic drinking cup and slides the table, which has wheels, across the bed. All mom has to do is lean up a few inches and she can sip her apple juice.

“Okay, sugar, I’ll be back later for your tray.”

I watch her go. Turning to mom, I smile. I am a Cheshire Cat. "Bon appétit!"

Mom again tries to speak, but nothing she says is audible.

Grinning, I reach over and take a napkin from the tray so I can drape it over her hospital gown. “C’mon now, sugar,” I say, mimicking the woman. “Baby gotta eat.”

Mom rolls her eyes. I take this as a positive development since it suggests she is engaged in the moment.

For the first time since the stroke, I feel marginally hopeful, although mom still grimaces at the sight of her food. Whatever else can be said about brain damage from the stroke, she knows bad food when she sees it. At least someone is still at home inside her head.

“Mmm, mm, good. It’s a dream come true — pureed food. Now, let’s eat up.”

Mom’s face is a mask of disapproval, but she reaches for her plastic spoon. She is on the road to recovery. I can’t help noticing, though, that she uses her left hand to grip the utensil. Normally, she is right-handed.

The road to recovery will be long and hard, but at least I can see a road ahead.