Читать книгу The Grandfather - Jesse Thomas Becker - Страница 6

October 1st, 1995

Dr. Fisher was a spritely man of moderate build. It was obvious that he had been in great physical shape at one point in his youth, probably from rowing or playing football, but the post-children years had seen inactivity and had equated to a slight increase in his pants size. He was not fat but not quite in shape either. His dark black beard was thick and speckled with white hairs, giving away his age. The beard, nicely trimmed, was grown, no doubt, to cover an evident double chin. Henry guessed Dr. Fisher to be in his late 40s. His eyes were dark brown, with dark ingrained crow’s feet stretching across his high cheekbones. He would have been a menacing character if he became aggressive, but something in the look in his eyes showed lines that were visible mostly due to smiling.

Dr. Fisher had advised Henry and Lee to visit his office to discuss his findings of their father. It had been two weeks and Pop Pop had displayed only slight progress. He still could not move his right side and was not talking. The only evidence he was not totally mute was an incident when he was heavily sedated and was yelling in what the staff and family thought sounded like German. He had gone back into unconsciousness for a few days, and when he awoke, he could not or would not speak.

Henry had visited his father every day for the last two weeks, trying to get him to communicate. He was finally starting to eat solid foods and sitting up and moving his right arms and legs, meaning total paralysis of the right-hand side was ruled out. But still, Joe was severely disabled. He could not walk at the moment but could slightly move his leg above the knee when asked by the physiotherapist. His right arm lay dormant by his side and he could maybe move his upper arm from the shoulder with 25% of the movement and point with his finger. Kristen, the physiotherapist, was pushing him to see how much function had been lost, and, since he could not speak, he had started to use a language board. He could easily point with his left hand to words to communicate, and, when asked to attempt with his right hand, he’d struggle, and the arm would jolt back and forth in a titanic movement to find the word on the sheet. He would get discouraged and used his good hand to assist his disabled hand to the correct work much to the dismay of Kristen his therapist.

Kristen noted in the first week that Joe had made remarkable progress. She had a great relationship with him as soon as she was introduced to him. She was cheeky, which Pop Pop liked. He’d smile that same smile he’d shared with all that he loved, but only out of his left side now, though the half-smile was still as endearing as the full smile.

She could be tough with him, though, which made him frustrated. He’d grunt and roll his eyes at her when she’d place an object just outside the reach of his right arm. He’d naturally try and grab it with his left hand, which worked fine. This would quickly elicit a prompt slap on the wrist from Kristen and a cheeky, “Now, Joe, we know your left side works. I need to see what your right can do.”

But within two weeks, she was having him grab and touch objects with a hand, not two weeks earlier that was almost completely immobile.

This is what the meeting with Dr. Fisher was about. He sat Henry and Lee down and said, “Joe is showing considerable recovery from a stroke. This was caused by an arterial embolism that started in his leg and traveled to his brain, causing a blockage of the recurrent artery of Heubner on the right side.”

Dr. Fisher turned his computer screen toward Henry and Lee and double-clicked an image. The MRI image on his computer showed an image that looked abstract to a layperson but showed something of importance to a man of his training and expertise. Henry and Lee both listened intently, pretending like what he was saying wasn’t complete gibberish, but even though doctors and specialists are trained to dumb down the information to the average person, they never get the balance quite right.

Dr. Fisher, not paying attention to Henry or Lee to see if they understood, continued. “This caused severe hypoxia and swelling to the left hemisphere. Your father initially lost 90% of his motor and neural activity in the left hemisphere of his brain, but in two weeks has rebounded considerably. The blockage is still 50%, but blood flow has been restored to this area of the brain, and with further physiotherapy and monitoring and adherence to medications, we expect him to regain his mobility and most of the function on his right side.”

Henry and Lee looked at each other, relieved. Both had seen the progress Pop Pop had made. But when they had asked the nurses and Kristen about his progress and future progress, they had been vague, letting them know it would take time but never giving any expectations.

Dr. Fisher continued, “I am suggesting the release of your father at the end of the week to either a family member, if you feel up to the task of looking after him, or I can recommend several facilities which specialize in this type of recovery. Joe will have to continue seeing the physiotherapist and myself for regular check-ups, but beyond that, he appears to be doing well, considering the trauma from the stroke. Do you have any questions for me?”

Henry looked at Lee to see if he wanted to speak. But Lee bowed, knowing the patriarchal position his brother had assumed required the etiquette of restraint, and allowed him to speak.

“What about his voice, doctor? Will he be able to speak again?” Henry looked over to Lee to see if this question was attuned to his brother.

“According to the MRI scans and neural mappings,” which Dr. Fisher proceeded to open and show Henry and Lee, “There does not seem to be any malfunction in Joe’s communication centers.” He pulled up another MRI scan which looked like an abstract image, this time with red dots. “See these dots?” asked Dr. Fisher, and both Henry and Lee nodded. “This area represents communication. Sound is processed and stored in areas of the brain next to each other. This is an image showing normal activity in your father during listening. We expect this, as communication is processed in the left hemisphere, which was not affected in your father’s stroke.”

“What does this mean?” asked Henry.

Dr. Fisher stroked his beard, as he did as a nervous habit. He leaned back in his desk chair that rocked back to levels of relative comfort and put his hand behind his head. This was the pose he spent time in when thinking. He leaned his head back and paused for a moment. The chair sounded an obnoxious squeak from overuse of the spring, as it was obvious this was Dr. Fisher’s thinking pose, which he spent many an hour doing.

He leaned forward and stopped rocking in his chair. “To tell you the truth, Mr. Harper, this means there is no neurological reason for your father’s inability to speak.”

Lee, finally ignoring the hierarchy of his brother, spoke before Henry could talk,

as he was anxious to get an answer. “Could the muscle paralysis have caused his inability to speak?”

Dr. Fisher lent forward and stroked his beard again as the chair spring creaked, causing Henry to squirm with discomfort,

“Maybe, but your father doesn’t seem to be having any problems swallowing or making sounds. This points to a neurological response. However, as I said, his communication centers are fine.”

The doctor reclined back, his arms crossed, using his muscles in his legs to push himself into an inclined position in his office chair, causing a loud squeak from the chair spring upon maximum extension, which told Dr. Fisher to stop leaning back. He thought for a second, then started stuttered,

“There are cases in which a second language is not learned in the communication section of the left hemisphere of the brain but in the creative section of the right hemisphere, usually learned in later life, where new neural pathways are learned in adulthood. Is there any chance English is a second language that Joe leaned in his later life?”

Lee, looking at Henry, bowed to him to answer.

Henry replied, “No, Joe was born in the US. His parents were Danish, but once they moved to the USA, they gave up Danish. Joe would tell stories of his grandmother that barely spoke English that raised him after his parents died in a tragic car accident, but they were mostly hilarious stories about how his Danish grandmother could not speak with him, due to his inability to speak Danish.”

Henry looked at Lee, who laughed under his breath, remembering the stories Pop Pop would share about their great grandmother getting so angry and saying Danish curse words which were the only foreign words Joe understood, because, as a teenager, if he heard “din lille lort”(“you little piece of shit”), he’d know he was in heaps of trouble and was going to get something in the kitchen tossed at him.

Dr. Fisher leaned forward in his chair and stroked his beard. “Well, potentially there is a psychological barrier keeping him from speaking because there are no neurological or physiological reasons for his silence.” He paused and looked at their father’s chart in front of him and continued, “The nurses, on the day he awoke, marked down that your father seemed to be babbling in German. He kept saying, ‘Ich bin kein…’ something. Were you there when he was doing this? Did you hear him mumbling?” Dr. Fisher paused to see if either Henry or Lee would take over on the path he was going down to suggest their father knew German. But when neither interrupted, he continued, “Did your father learn German rather than English?”

Henry, a little agitated, feeling like the doctor hadn’t believed him, answered on the offensive. “No, doctor. Joe only spoke English. He may have known some German from his time in the war, but he never spoke any German in our house ever.”

The doctor, realizing his inquiry was starting to elicit emotion and beginning to agitate both Lee and Henry, quickly changed the subject. “Well, my findings suggest Joe will be able to regain his speech, and, working with the physio and speech therapist and potentially a psychiatrist, I suspect Joe to have great mobility and become ‘normal’ for someone who has undergone such a horrendous stroke.”

Looking at the wall clock, the doctor realized the 30 minutes he had allotted for this meeting was nearly up. He took control and wrapped up the conversation, standing up and shuffling Henry and Lee towards the door like a well-trained sheepdog.

“I suspect Joe will fully recover his communication. However, I cannot give you a timeline for his recovery. Joe will be released from the hospital this Friday. If you need assistance or information on care facilities, do not hesitate to ask my receptionist. Thank you for coming in.“

Henry rose and shook the doctor’s hand saying, “Thank you, Dr. Fisher,” as did Lee. Both felt rushed but understanding Dr. Fisher was a busy man, they turned and walked out the door, exiting the neural ward and entering the elevator together.

Lee was the first to speak when the elevator had made it about one floor. “What do you think he meant by the German stuff?”

Henry shrugged, looking mildly worried. “I don’t know. But I do remember Dad mumbling when he woke up. He was saying, ‘Ich bin kein schlechter Mensch,’ or something like that. I remember he said it a few times, mustering all his energy to yell it, before passing out.”

Lee interrupted, a bit upset. “What did he say again?“

Henry responded, unsure he was saying it right, so stumbling on each syllable, “‘Ich bin kein schlechter Mensch,’ or something like that.”

Lee, whispering under his breath, not looking at his brother, said, “I’m not a bad person.”

“Excuse me?”

Lee spoke in an audible volume to his brother. “‘I’m not a bad person.’ That is what ‘Ich bin kein schlechter Mensch’ means.”