Here is Chapter 8 of Dreaming Out Loud, the book about my mother’s stroke.
My aunt Polly arrives in Atlanta ready for action, as is her custom. Although she, like her sister, is wheelchair-bound, Polly has lost none of her vitality with time and age. Something about her personality refuses to yield; she is a woman who will not succumb to illness or weakness. Illness and weakness are unbecoming, and Polly loathes unbecomingness.
Her hair is gray, her figure slightly stooped; her hands are twisted and misshapen by arthritis; her once proud figure is ravaged by giving birth to four children and struggling through more than seven decades of life. Despite these challenges, she carries herself with enviable dignity accompanied by an aura of majesty that never ceases to leave me gaping in awe.
Her husband, the long-suffering, good-natured, unflappable Loren, a man of the cloth, pushes her wheelchair toward us as we stand in the baggage claim section of the Atlanta airport. He is physically strong — far stronger than his wife. A lifetime of discipline and physical exertion has served him well. He watches what he eats, walks and swims vigorously when he can, and never allows his brain to rest from the hard work of plowing through turgid philosophy and theology texts. He probably will outlive us all.
Paula, Shelby, and I resemble logs lodged in the middle of a shallow stream. A torrent of strangers flows endlessly past us, striking us with their limbs. I fight feelings of claustrophobia as I scan the area until, from amidst this swirling glob of humanity, I spot them waiting near the luggage carousels. I wave, but they do not see me.
Polly sports thick half-glasses perched low on her nose. Loren’s shock of white hair, thick but askew, reminds me that they, too, are fragile creatures. They are intent on identifying their bags; they do not look up as we weave through the masses.
“Polly, Loren.” My soft voice is swallowed by the ambient noises of the airport. Paula and Shelby trail behind as I thread my way through the crowd.
My relatives do not recognize me at first. The shock and fear written on their faces when they turn to look at me stops me in my tracks. A second later, they break into warm smiles, and we embrace. I will not soon forget the fear etched onto their faces, though.
After we exchange pleasantries and retrieve their luggage, we head for the car. I sketch a rough outline of events that have occurred since our last telephone conversation, and they utter the appropriate noises. Loren is stuffed into the back seat with Paula and Shelby while Polly and I ride in the front seat. The trunk is packed with suitcases and a wheelchair.
“Laura is strong.” Polly mumbles this hopeful phrase repeatedly as though reciting a mantra. “She will overcome this.”
I want to believe her, but I have seen the 64-year-old, stroke-addled Laura. Polly will learn soon enough, so I say nothing.
We glide along the interstate highway mostly in silence. Loren politely asks Shelby what grade she is in and how she likes school, and she responds appropriately. We all play our parts as well as we can, but everyone wonders the same thing: What happens now?
What happens is we go home to let our guests rest and freshen up. We allow several hours of respite before we head back to the rehab unit.
By this time, mom’s stroke has played out. Her brain apparently is still swollen, but she has regained consciousness and appears less lethargic than she appeared during the first days of what the medical professionals euphemistically call the “cerebral ischemic event.” I am pleased to see how alert she is when we enter her hospital room. Her eyes light up with recognition as we step inside.
“Laura.” Polly wrenches control of her wheelchair from Loren and rolls close to the bed. The sisters attempt an awkward quasi-hug, although my mother cannot lean down from her bed and Polly cannot lean up her chair. They forgo the hug as Polly grasps her sister’s left elbow and they gently rock in a rhythmic motion. A moment after they break away, Loren steps forward, leans down, and embraces his sister-in-law.
“The grounds here are simply lovely.” Someone must fill the silence, and such tasks are Polly’s specialty. “The azaleas are huge and will be stunning when they bloom. And was that a wisteria vine I saw next to the back fence? Loren, was that a wisteria vine?”
“I believe it was wisteria.” He confirms this vital bit of information with a slight nod.
“The lovely shade trees, the way they keep the lawn immaculately trimmed. Even in winter the grass is green. That’s absolutely amazing.”
“It is amazing.” Smiling a thin, hollow smile, Loren agrees.
“They certainly keep this place in shape. I don’t know what that says for the level of care, but if it says anything about the quality of treatment, you are in good hands.”
We all look on at this bubbling display of optimism with admiration. Polly can take over a room with her enthusiasm, whether real or manufactured. That enthusiasm is a welcomed development since the rest of us stand around feeling mostly numb and exhausted. Enthusiasm and I have become estranged lovers.
Mom had been gumming a mouthful of pudding when we entered. The TV is turned on, tuned to CNN Headline News, but muted. With much effort, she struggles to swallow, her face contorted into a grimace.
Polly notices the expression of disgust. “The food here is pretty bad.”
Paula speaks. “It’s a pureed diet.”
“How awful.” Polly’s voice exudes sympathy. Like her sister, she is a connoisseur of large, elaborately-prepared meals featuring a multitude of gravy-drenched meats and fancy casserole dishes. “I wonder if they will allow you to bring in outside food.” One thing about Polly — when she sees a problem, she schemes to fix it.
“Not for a little while.” Paula is the expert in the room. “After a stroke, there’s concern about choking hazards. It’s difficult to swallow.”
“I see.” Polly appears nonplussed.
Mom continues to shovel pudding in her mouth, but clearly she is unhappy. Outside food smuggled onto the premises would brighten her day immensely.
Without missing a beat, Polly changes the subject. “Does everyone else have a place to sit?”
Paula and I exchange glances. “We’re fine.”
“Loren. Please see if you can find us a few more chairs.”
“Right.” Loren marches into the hall.
“So, Laura.” Polly takes a deep breath. “It’s so good to see my baby sister again. You had us all very worried.”
“Scotch?” Polly smiles. “I would love some Scotch. But you are not talking about Scotch, are you?”
Mom shakes her head. “Scootch scootch.” Pudding dribbles into the corners of her mouth.
Everyone in the room looks at her blankly. Her voice sounds impaired, guttural, almost intoxicated in the way she slurs her words.
Mom groans and grunts in her new guttural language. We crowd around her bed and cock our ears to better hear her comments.
“Scootch scootch.” She repeats her new catch phrase, this time wagging her finger back and forth.
Polly takes charge. “Are you thirsty? We can get you some water. Mike — get your mama some water.”
“Yes, ma’am.” I step toward the sink, but mom shakes her head vigorously. That is not what she means.
“Do you want me to unmute the TV?” I reach for the remote control pinned to the pillow beside her head.
Mom gazes at me as though I have offered up the dumbest comment ever uttered by a human being. Again, she shakes her head vigorously. She slaps at my hand.
“Scootch, scootch.” She repeats the words slowly, as though speaking to a slow learner. Her hand waves back and forth; she is conducting lightning quick movements for an unseen symphony orchestra.
Polly smiles. “Are you asking how our trip was? It was fine, uneventful. Just tiring. I’m not as young as I used to be. I came in the wheelchair, but it’s difficult to negotiate the airports, as you well know.”
The monologue angers mom. She shakes her head more vigorously than ever.
“Perhaps we should get a nurse.” This comment reflects Polly’s method of shifting the responsibility onto someone else’s shoulders. We need to bring in experts to advise us on stroke-speak protocol.
Mom grunts. That suggestion, too, is vetoed.
As ever, Paula seizes control of the situation and arrests our downward slide. “Look here, Laura. We are trying our best to figure out what you want. Obviously, we don’t know. What else can we do?”
As if on cue, a nurse glides into the room. She is not the same cheery soul we saw previously. This is an elderly Caucasian woman. We can tell by the way she carries herself that she is a lady accustomed to being in charge. She stops, plants her right fist on her beefy hips and surveys each of us in turn. She holds a thick manila folder tucked under her left arm.
“Are you the family?”
Polly is no stranger to authoritative stances. “Yes. I’m Laura’s sister.”
Loren stumbles into the room carrying two chairs. “There are several more in the waiting room down the hall. Mike, would you help —.” Seeing the nurse, he stops and his voice trails off.
“Are you a family member?”
“Yes.” He nods, but without his collar affixed to his shirt he lacks the requisite gravitas.
“Can I please see you all outside?” She cocks her thumb over her shoulder in a gesture of authority that cannot be ignored.
We follow her, single file, into the hall.
I place my hand on Loren’s arm. “I’ll help you get the other chairs in a minute.”
Polly speaks as she rolls from the room. “We’ll be back in a moment, Laura.”
The nurse leads us down the hall without comment. We struggle to keep up with her. Polly rolls behind the assemblage and Loren drops back to assist.
“Go on. We’ll catch up.” He waves his hand.
In response, Paula, Shelby, and I double-step and break into a quasi-jog so as not to lose our potentially-elusive quarry.
The nurse halts at an unmarked doorway, removes a key from the confines of her uniform, and unlocks the door. Flipping the light switch, she enters the room and gestures toward a bank of chairs. “Please take a seat.”
We enter a medium-sized, all-purpose office. I say “all-purpose office” because the décor is generic. A metal desk is stuffed into the corner but it is free of papers, folders, or personal effects. A print of a deer frolicking in a snowy field while looking back over his shoulder is matched by a watercolor of a forest scene depicting dark-looking woods with a deep rich brown frame that resembles the shade of the trees. The prints remind me of lines from a Robert Frost poem:
The woods are lovely, dark, and deep, But I have promises to keep, And miles to go before I sleep.
Paula, Shelby, and I sit. A few seconds later, Polly and Loren appear in the doorway. He rolls his wife over next to me and sits on the other side of her wheelchair. By a nice coincidence, we have exactly enough chairs in the room for the people inside. Polly must be pleased.
“How old are you, dear?” the nurse asks as she looks at Shelby.
The nurse looks around at the rest of us. “Do you want her in on this conversation?”
Paula shrugs. “That depends on what the conversation is about.”
From the expression on the lady’s face, I have a bad feeling. Good news is seldom delivered with such a foreboding prelude.
“I want to talk with you about Mrs. Martinez’s progress — or lack thereof.”
Shelby resolves the problem to everyone’s satisfaction. “It’s okay. I’ll watch TV with Nana.”
Paula nods. “Don’t go anywhere else.”
“Can I have money for the vending machine?”
I reach into my pocket and retrieve a couple of wadded-up dollar bills, which I hand to Shelby without comment.
The nurse closes the door as soon as Shelby is gone. “Now, then. My name is Mrs. Rose. I am the chief diagnostician here at Joan Glancy.”
I always hate it when people introduce themselves formally by inserting a title — mister, missus, doctor. It always strikes me as condescending and cold.
“And now that you know who I am, who might you be?”
I want to say, we might be a band of roving gypsies, but we aren’t. I refrain. “I’m Mike Martinez, Laura’s son.”
“I’m her daughter-in-law.” It isn’t true just yet, but close enough for this meeting.
“As I told you, I’m her sister, and this is my husband.” She points at Loren.
With the introductions completed, Mrs. Rose sits at the desk, slips a pair of half glasses onto her nose and flips open the folder she has been carrying under her arm. “As I am sure you know from your discussions with Ms. Springs, we initially believed that Mrs. Martinez was an excellent candidate for the aggressive therapy regimen we have here at Joan Glancy.”
“Initially”? What does she mean by that?
“Unfortunately, it seems that Mrs. Martinez is being most uncooperative.”
Paula frowns. “Uncooperative in what way?”
Mrs. Rose adjusts her glasses and clears her throat. “Today we began her initial therapy in the gymnasium. It is by all accounts a very aggressive program designed to test a patient’s strength and stamina. A kind of stress test, if you will.”
We all nod.
“At first, Mrs. Martinez tried to walk, but when she found it to be too difficult, she simply refused to do more.”
“Maybe she was tired.” Polly knows what it is to be tired.
“Undoubtedly she was tired. That’s the whole point. We push patients until they cannot be pushed any longer.”
Paula speaks. “It’s still been only a few days since the stroke. Maybe she’s not up to the strain.”
“Perhaps. But it’s more than that. Throughout the day we attempted to get Mrs. Martinez to undergo additional testing and try other exercises, but she flatly refused. There was no getting her out of bed. In fact, she used her good arm to grasp onto a metal bar beside her bed and refused to let go. She almost pulled it from the wall.”
That is my mother all right — stubborn through good times and bad.
Polly rubs her chin. “What can you do?”
Mrs. Rose sighs. “That’s just it. There is very little we can do. This is an aggressive rehabilitation center, as you know.” There is that word again: Aggressive. “But we cannot force a patient to participate in physical therapy. It’s against the law. Even if the law would allow it, the therapy only succeeds if the patient willingly participates.”
“So what do you suggest we do?” Polly sounds alarmed.
Mrs. Rose smiles. Now we have arrived at the heart of the matter. “It is so important that we have family support. If you can talk with Mrs. Martinez and explain to her that she must participate, I believe that will go a long way toward improving her chances of recovery. But you will have to do it. She won’t listen to the staff.”
“We’ll certainly speak to Laura.” Polly can be persuasive when she sets her mind to it.
I know my mother pretty well. Sometimes it takes more than just speaking to her to change her mind. “What happens if she still refuses to cooperate?”
Mrs. Rose nods as though she has expected just such a question. “Unfortunately, Medicare provisions require that the patient demonstrate weekly progress. If Mrs. Martinez cannot show a good faith effort, we will have to release her to a less aggressive rehabilitation center.”
The room falls silent as we consider this discouraging news. We have selected the Joan Glancy Center precisely because it is aggressive. The neatly manicured lawns look good on the cover of the brochure, but we mostly want intensive treatment for mom. It seems to be her last best hope for a full recovery, if such a thing is even possible.
“How long do we have?” Paula is once again a pragmatist in a family overflowing with idealists.
Mrs. Rose scribbles something in the file folder. “If she can demonstrate some kind of progress in the next few days, we will be okay this week. After that, we will take it on a week-by-week basis.”
Polly picks up on the thread of the conversation. “How long does a recovery usually take?”
Mrs. Rose reaches under her eyeglasses and rubs her eyes. “That is difficult to say. Every patient is different, and every injury is different. Some patients are up and out in a few weeks, perhaps a month. Others take far longer.”
Paula stands. “Well, then. We have our work cut out for us. Convincing Laura of anything is no easy matter.”
We find Shelby watching TV as our group hobbles back into mom’s room. Mom seems to be semi-awake, staring up blankly at the ceiling.
In coded euphemisms, Polly suggests that we not attack the situation head-on. Mom has never reacted well to direct confrontation. Subtle chicanery is our best bet. I marvel at Polly’s quick, accurate assessment of the patient’s psychology, and I wholeheartedly agree. We will practice the delicate art of trickery.
Mom lifts her head when she sees us. “Scootch scootch.”
Loren and I each carry a pilfered chair. “Are you asking about the chairs, mom? We got them from the waiting room.”
The impatient tone of her voice tells us that she is asking a different question. We correctly deduce that she is curious as to what has been said outside her presence. My mom cannot stand someone talking about her welfare behind her back. Even after suffering a stroke, she needs to be part of the decision-making process.
“The nurse wanted to review the policies and procedures for the facility.”
Paula and I look at each other and struggle not to grin. Polly fibs with an ease and familiarity that all Southern belles know well from their years of etiquette training in the Junior League.
This white lie must satisfy mom, because she does not pursue the matter.
“Finished?” Polly surveys the tray of half eaten food.
Mom grimaces. Yes, she is finished with the sorry excuse for a meal they serve in the rehabilitation center.
“We’ll see what we can do to smuggle you in something better.” Polly’s stage-whisper is almost comical.
“It has to be a pureed diet or she could choke.” Paula does not want the conspiracy to get out of hand.
Polly and mom look at each other and roll their eyes, almost in unison. It is good, I suppose, to see sisters united against a common enemy.
We sit in our purloined chairs, arranging them in a semicircle around the hospital bed, and reminisce about old times. Occasionally, we turn up the TV to watch an amusing scrap of news or we pause to feed Shelby more money for the vending machines or we entertain mom’s repeated, and probably insincere, entreaties to leave, but otherwise we pass the time swapping stories. Mom’s contributions are the disquieting “scootch scootch,” but we usually derive the meaning from the context. From time-to-time, the roommate, Ida, barks out orders from behind her curtain for us to “hush up,” but she may be tripping through her own bout of chaos and confusion.
That is how we spend our first night of Polly’s visit.