Authors: Robert McCrum
Things slowly improved. I was beginning to make progress in speech therapy, though the effort of articulation remained a problem for me long after I left hospital.
Each morning, when I woke up, I would repeat as clearly and sharply as possible:
Round and round the ragged rocks the ragged rascal ran
; and then (Sarah’s favourite):
Theophilus Thistle,
The thrifty thistle-sifter,
Thrust three thousand thistles
Through the thick of his thumb.
I was in the middle of these exercises one morning, lying in bed with my eyes closed, when I became aware that the catering manager was standing at the foot of my bed staring at me in amazement. It was clear from his expression that he’d decided I was not only sick but mad as well.
Veronica, my new speech therapist, turned out to be firm, friendly and positive, not at all reluctant to say what was all too obvious to me: my speech was still badly slurred. That was quite normal, at this stage, apparently. Veronica, a brightly dressed, maternal woman with large spectacles, also told me I had a right to feel exhausted all the time. She was very direct and
down to earth and breezily bossy, a change from some of the therapy I’d had at Queen Square. She was the first person who really spoke the truth about what had happened to me, and she gave me quite a hard time about my speech. Early on, she asked me to describe my day, then criticized the slurred way in which I articulated. As a contrast to Veronica, I think I found the nurses’ and doctors’ reluctance to commit to definite pronouncements about my condition and my likely convalescence the most frustrating part of these months.
I sat on a stool beside R. when he had physical therapy today. He lay on a table and tried to move his leg. He can bend the knee up and, once it’s bent, he can keep it there. A contrast to the first weeks, when it would slide back down like an ice cube on a hot surface. His arm is in a sling because they don’t seem to think there’s any movement in it, and they’re afraid it will flop around and be pulled out of its shoulder socket. He can’t move his foot yet (though I thought I saw movement there yesterday). When we got back to his room he got out of his wheelchair and tried to get on the bed, and miscalculated and fell helplessly. He ended up on his stomach and couldn’t manoeuvre himself around. His leg and arm got caught and it was very painful for him, and very sad to watch, like a beetle tipped on to its back, or a fish on shore. I feel like my heart is very slowly deflating. But even as I see him go through this I am filled with such love.
R. just phoned. When he gets tired, his voice gets fuzzy and slurred. They say that will go away over time but, like a lot of this, it’s an alarming feature and you worry that it will be permanent. He’s been moved to a
better, bigger room, so some of the nightmarish circumstances of the last few days – having to move all the furniture around so he can be wheeled into the bathroom for his shower, for instance – won’t be repeated again. He says he still feels blue. But he says his blueness has a bit of pink around the edges.
The part of convalescence that I found most profoundly humiliating and depressing was occupational therapy. Here, the admission of cerebral failure was even more stark. I was reduced to playing with brightly coloured plastic letters of the alphabet, like a three-year-old, and passing absurdly simple recognition tests. Sitting in my wheelchair with my day-glo letter-blocks I could not escape reflecting on the irony of the situation. If only Milan Kundera, Kazuo Ishiguro, or Mario Vargas Llosa, whose texts I had pored over with their authors, could have seen their editor at that moment!
R. took his second occupational therapy class today. Yesterday, he had to go through a list of letters and check off all the Es, and then look at a row of trees and put them in order of size – some people are so badly off, apparently, that they can’t do those things. Today they taught him how to get out of bed – but he can already do that, too, using his good right leg.
My new room had a much bigger bathroom, and less street noise. On the telephone I found myself telling callers I was ‘blue’, which was an understatement. I realized I had to get used to a long-term approach. If I was lucky I might be on the road to recovery by Christmas, but not sooner.
Neurology’s favourite word is deficit, denoting an impairment or incapacity of neurological function: loss of speech, loss of language, loss of memory, loss of vision, loss of dexterity, loss of identity …
Oliver Sacks,
The Man Who Mistook His Wife For A Hat
In the Devonshire Hospital, devoting two or three sessions a day to my gradual rehabilitation, I became more than ever acutely aware of what I had lost, of my ‘deficits’. I seemed to have been pitched forward into old age, and much of my anger came from the daily war between a youngish man’s spirit and imagination, and what I cursed as an old man’s body. Outside my window, even the changing season seemed to conspire to underline that I had fallen into ‘the sere, the yellow leaf’.
When the early-September rain came, it was like a curtain being pulled over the high season. Once autumn arrived, I felt robbed of the hot summer, and this no doubt contributed to my depression. Autumn had always been, for me, a good time of year, and not being able to have it, I felt very frustrated. Autumn was the
time of beginnings, of the new school year, of fresh starts, and yet here I was, trapped and helpless. I longed to get into a car and drive two hundred miles to the waves and wild wind of the West Country. Instead the Christmas holiday, then four months off, became my personal goal.
I told myself that if I could be home and semi-recovered by then, things would not seem so bad. Throughout my recovery I found it helpful to set myself limited short-term personal goals of the kind I had a reasonable expectation of achieving. At this stage, I still could not imagine being able to walk, though Davina reassured me that this would happen. Having a goal for the immediate future made the present more bearable, and gave me a target towards which to direct my convalescent energies. I told visitors to my bedside that my top priority was ‘myself’, and in the circumstances this assertion seemed neither self-centred nor unreasonable.
I can’t believe it’s been the whole month of August. It seems like forever, actually. R. put weight on his weak leg today (with Davina’s help) and was able to take steps with the other one. Better, he said, than he could do yesterday. I spoke to the occupational therapist who said walking depended on Robert – that if he did it his way, he’d be able to walk within a month, but badly, but that if he was patient and waited and did it the way he was told, he’d be restored 75%–90% of what he had before. It’s hard to comprehend all this. I try so hard not to think about what our life is going to be like later, because it’s wrong (or counter-productive) to flood my mind with enticing fantasies, and equally wrong to flood it with black, doomed scenarios. R. looks so healthy; it’s
hard to believe this has happened. I’m afraid for him to come home because the contrast for both of us will be so great, his condition now, compared to his condition before. The occupational therapist wants to come home and look at the house and see if we need to put a ramp in (for wheelchair access). Temporarily? I said. Temporarily, she replied. I feel close to panic all the time.
Meanwhile, as a milestone of progress, I was sent for another MRI scan. It was, I suppose, a measure of my recovery that I was now taking an interest in the technical side of Magnetic Resonance Imaging (MRI), a technique for scanning the brain which exploits the fact that hydrogen atoms resonate when bombarded with energy from magnets. Like its cruder predecessor, the CAT (Computerized Axial Tomography) scan – which I’d had on first admission to University College Hospital – MRI displays three-dimensional body images on a screen; its main advantage is that it does not involve radiation.
If my mind was sufficiently recovered to enjoy this kind of scientific information, physically I was still incompetent. I was still being bundled in and out of the ambulance on a stretcher. Now that I was much more alert than previously, I could take in, and respond to, the experience of MRI. The scanner – a narrow, cigar-shaped capsule – seems terrifyingly claustrophobic to some people. Sarah, for instance, said she could not imagine being in a space so narrow and cramped and loud, ‘like blood pounding and people operating heavy drills and alarms sounding’, but I found to my surprise that it was an interesting experience, not frightening at all. I think we both wondered what the scan would reveal. Would it, for instance, explain why my left arm
was still not moving? My thoughts ran on: what if it never moved again? How would that change our lives?
The next night, Dr Greenwood, whose punishing work schedule with National Health and private patients always necessitated late-evening visits, came and showed us the result of the MRI scan. The clot – still a black blob the size and appearance of a Rorschach ink-blot on the negative – was much reduced in the brain. When I questioned him about my left arm, he admitted that when it came to the convalescent powers of the brain he and the other experts were still pretty much in the dark, though the current orthodoxy was to believe in cerebral ‘plasticity’. Richard Greenwood was obviously a clever man, and I found myself wanting to impress him. I told him I’d come to the conclusion that having a stroke was like having one’s personal wiring ripped out: everything stops, the electricity of one’s body fails, and the wiring of one’s association with the world also. So the things that had once seemed so important for everyday existence no longer seemed important at all. At this time, I was in a mood of existential crisis, a mood that can still easily recur, lending the world a strange, provisional air, even now.
Robert seems to get a tiny bit better each day, and that does seem to be what they told us would happen, and the best we can hope for. Today he was actually sliding his foot around a little (with help from Davina), and taking the first tentative steps. He’s not strong enough to do it on his own. As R. made what to me felt like a breakthrough, the two other mats in the gym were filled with two other stroke victims. One, a young Arab man,
was groaning and drooling and listing wildly to one side. He couldn’t seem to move at all, and one of his eyes was mostly closed. He looked so weak and lost. The two therapists with him asked him what number his room was, and he couldn’t (whether mentally, or just physically, I don’t know) answer. They told him, and one said, ‘I want you to remember that when you go upstairs.’ She sounded like a nursery-school teacher. Behind him was an older man who can’t move, either, and who just sat in his chair and stared listlessly. Occasionally he tried to mumble things, and the therapists tried to interpret what he was saying. Thank God, thank God, thank God, this hasn’t happened to R. Compared to them, he’s as good as sprinting in the 100-yard dash.
My convalescence continued, inexorable and infinitesimal from day to day: after about a week in the Devonshire, I had mastered the daily washing ritual. I could manoeuvre myself out of bed into the wheelchair, and wheel myself with one hand into the bathroom. There, I would have a one-handed shave and clean my teeth. I would gingerly transfer to the plastic chair under the shower, turn on the water – braving the first chilly blast of cold water – and wash my hair. Then I would pull the cord to call the nurse, take the towel, dry myself, transfer back to the wheelchair in the room, slowly get dressed, dry my hair with the hair-dryer, sit in the chair and write my diary. It’s easy to describe, but in practice every step was painfully slow and laborious, fraught with the fear of falling over.
I was grateful, meanwhile, for the steady flow of visitors; occasionally I sensed that I’d become an object of mild social competition among some of my friends. I found that visitors in hospital are fascinating. Some
people (whose blushes I will spare) became quite indiscreet, almost confessional, at my bedside, both much more personal and more forthcoming. I was told things in the privacy of my hospital room I would never have heard in a decade of drunken evenings. Perhaps, confronted by the stark and unavoidable evidence of human failing, my visitors felt obliged to expose their weaknesses and share their own private foibles. Such moments created some very special bonds with a wide range of friends and acquaintances, and sometimes with the people I least expected.
I remember that my friend the writer Michael Ondaatje, who turned up one morning unannounced, and who was usually so cagy, became positively voluble. He was passing through London en route from the filming of
The English Patient
in Italy, and spoke effusively about the performances of Ralph Fiennes and Kristin Scott Thomas, and about the magic of the Tunisian desert. It was wonderful to see him, and we talked for over an hour. Another visitor, who braved the crowd of robed Arabs habitually clustering in the hospital foyer and whose irrepressible presence brought great energy and joy into a black moment in my life, was Salman Rushdie. Of all the people who came to see me, it was he who somehow managed to leave behind his very considerable tribulations at the door and to focus his attention on me. I had been attempting to read his novel
The Moor’s Last Sigh
but, physically unable to hold it open for more than five minutes at a stretch, had been failing miserably. I shall never forget the moment when Salman very sweetly read a page from the opening chapter, ‘doing the voices’ with characteristic brio.
One of my most regular visitors was an old friend, Brian Wenham, a distinguished BBC broadcaster who’d
suffered a heart attack as a young man and retired early in his fifties. I cannot say exactly what it was that Brian brought to my bedside, apart from sympathy, several bottles of superb white wine and some very good jokes, but I always felt much better for his appearances. Brian always spoke of having a stroke or a heart-attack as like being caught in a ‘biological car crash’, that is, a totally random event, without meaning, and quite beyond our control, which was a helpful and consoling way to look at it. Brian Wenham died very suddenly as I was writing this book and his death removed one of the most vital props of my convalescent life, a mentor in the truest and fullest sense of the word, someone I trusted completely and who provided the kind of wisdom that no one else could match. I cried at his funeral in a way I had not cried since my days in the National Hospital.