September 11 – 27, 2018
The night of September 10, I peacefully drifted to sleep in our tent, anticipating 20 more miles of nature’s beauty before our next town stop.
As far as my brain was concerned, I woke from that night to find a nurse putting a finger bowl in front of me, urging me to clean my fingernails. I looked around fuzzily. Obviously I was in a hospital. I’d been hiking without a shower for five days, so it made sense that my hands and fingernails were not up to a hospital’s standard of hygiene. My sense of humor rose to the surface. ‘A finger bowl?’ I thought. ‘Is cleanliness that important here? What would they say if they could see the amount of grime we are exposed to on the trail!’
It took a bit for me to get the events of the accident straight, including the fact that, unbeknownst to my brain, I had been conscious and lucid for hours.
Human brains are truly amazing. Reaction to extreme stress varies from one person to another. I am grateful that PTSD is more widely acknowledged and better understood now. I have total amnesia of the 36 hours after the accident. My brain only decided to check back in when my funny bone became engaged! Jay was also reliving the nightmare at odd times, many things acting as triggers.
While at the hospital, we requested and received some very good advice from a therapist. She told me not to stress about the amnesia, it was a common reaction. She told Jay that his “flashbacks” were also a common way for his brain to try solving the problems the accident presented him. She told us to take charge of our brains. Later, when we found ourselves in a safe and secure place, it would be good for us to discuss the details and the feelings from the accident. But while we were still in the accident’s aftermath, it was important to compel our brains to stay in the present.
“When you begin to feel stressed, or your brain begins to tramp a circular path, you can force it to stop by finding something in your surroundings that takes your attention. Stay in the present. Even if you just look for five red items in your environment. It’s important to stay in the present until you’ve had some time to heal.” The therapist’s words stayed with us.
Another wonderful help was an email to Jay from his sister, Nancy. She gave him a tremendously superb list of things to do for me and for himself.
Of course, the hospital personnel had done a number of vital things to me before awakening my sense of humor with a finger bowl. They had stitched my neck closed, restored a good bit of my lost fluids with an IV, and determined the presence of a small bleed in my brain, a pseudoaneurysm in my carotid artery, a bruise on the right side of my brain, eight broken bones in my face and a shattered left jaw, as well as an occipital condyle fracture (a fracture of the bones where the spine joins the head). The jaw bones required surgery, but the (now stopped) brain bleed and the occipital condyle fracture prevented surgery. The doctors finally determined that I had to wait for the occipital condyle fracture to heal and get off the aspirin that had been prescribed for the pseudoaneurysm, then I would require reconstructive surgery to put my jaw back together. I also had extensive bruising both on my face and inside my mouth, causing swelling which led to temporary problems with swallowing and breathing. That tree branch had a lot to answer for!
Jay and I cannot say enough good things about the staff at Harborview Medical Center. Nurses and doctors both explained things very clearly and listened and responded to our concerns. Several of the nurses also listened to my flights of whimsy as my beleaguered sense of humor struggled to stay with me.
Many specialists were involved in my care. One nurse taught me how to swallow with the very swollen throat. An occupational therapist made sure I could walk. Jay was given lessons in the care and changing of my neck brace. A physical therapist checked my ability to turn in a circle, climb up and down stairs, squat and stand without use of hands. As I obediently struggled to stand up from a squat without pushing off from the floor, my sense of humor observed, “you couldn’t even do that reliably before the accident!”
On the last of my five days at the hospital, a speech therapist was tasked with checking my cognitive function. I was asked many basic questions such as my current location and the date. Then I was instructed to listen to a story and retell it. The story was a very simple but unbelievable tale of a woman who lost her purse in a store, only to eventually get it returned by a little girl. I couldn’t resist giving my opinion of the events in the story as I retold it. The speech therapist was not impressed. Later in the cognitive test, I was asked to remember and retell the story. I did so, with even more embellishments. I could see the speech therapist did not appreciate it when I went “off script”, so each time I would reassure her, saying, “I know, that wasn’t part of your story.” When I finished, I tried to explain that I had been raised by an award-winning storyteller, and I couldn’t just leave the story in its implausible simplicity. The speech therapist wasn’t listening at that point. Instead, she gave a little talk concerning how Traumatic Brain Injury can cause a person to have difficulty in focusing on a story line or task. She conceded that I perhaps showed awareness of my inability to focus when I acknowledged that my asides were not part of the story. She also said that if my family thought this behavior was normal, there wasn’t as much concern.
“She’s been that way always,” Jay told her.
“She’s always done that,” my sister, Helen, added.
A few minutes later my son, Daniel, walked in and was told that the speech therapist was testing me by having me retell a story. “Oh boy,” he said with a little shake of his head. Everyone laughed. The speech therapist finally relaxed a little, saying she liked the way our family interacted in this situation.
Jay requested help from our son and sisters early in the hospital stay. We remain very grateful for their prompt and loving response.
Our son, Daniel, was the first to arrive, his smiling face making my cup of joy overflow. Daniel brought Velveteen, his childhood toy, as well as our duffel bags of non-hiking clothes. Velveteen has had decades of practice at banishing nightmares, and he truly helped me stay “in the present” for the duration of the hospital stay. Daniel’s quiet common sense often meant that he had taken care of something before it could even be noticed, much less become a problem! His practical help and effervescent sense of humor were the perfect medicine!
My sister, Helen, was the next to arrive. She found a furnished apartment just four blocks from the hospital where my three care givers could get much needed sleep. She also took over night duty by my bedside at the hospital. (Jay had been awake nearly 48 hours by the time Helen arrived!) Her medical knowledge helped Jay not to miss anything important that the doctors told us. She also was an excellent advocate and facilitator of information between the many medical teams involved in my care.
After I was released from the hospital, Daniel and Helen returned to their normal lives.
Jay’s sister, Nancy, arrived next. With her home health care training, she was a huge help as we adjusted to living in an apartment. Nancy assisted with my personal care, such as showering. She brought comforting reassurance when helping Jay with the daily change of my neck brace, a four-hand job. She quickly helped us fall into a schedule which included lots of sleep and a daily walk for me. She also provided a blender, such a practical and necessary gift!
When it was time for Nancy to return to her own family, my friend and sister of my heart, Linda, arrived. Linda is a veterinarian, so once again we were able to benefit from specialized medical knowledge. Linda’s visit helped me transition to doing simple actions for myself. Mostly, we were blessed with her unique and fun point of view.
Sixteen days after the accident, our last helper went home, leaving Jay and me on our own in the big city of Seattle! My convalescence continued…