Wednesday, June 28, 2006

Bob's brain

surface tension
Originally uploaded by pwilnyc.

None of the four of us get sick very often. When I get sick, it's generally just a crappy cold. I try to milk it so that I can get a night of two of lying in bed watching TV, but truth be told I'm really not that far under the weather. When the kids get sick, the worst part is the chapped nosies.

But when Bob gets sick, he is unconscious. He came home from work today before noon, hit the couch still wearing half his suit, and dropped off the face of the earth. He had been up all night making trips to the bathroom. He's been pretty stressed-out lately, and apparently his brain is attempting to exit his body. Through his ass. Forcing everything in front of it out first.

I can definitely understand his brain's need for a vacation. But I wish I could tell it that the Baltimore City sewer is probably not much more relaxing than the Baltimore City Public School System.

I tend to blame Bob's brain for anything that's wrong with him. It fucked me over once, and I am not forgiving it. Here's how it happened:

June 17, 2002. We had just moved to Baltimore. It was a gorgeous day. Big Man was 9 months old, and I had just that day found the mythical neighborhood playgroup of intelligent funny moms who all had boys his age.

So, all jazzed up from talking to adults, I suggested that we take a little field trip and have dinner out. Gorgeous day (I said that but it's worth repeating). We drove to Annapolis, got a good parking space, and took a table at that big old historic tavern job on the water. Ordered our oyster shots, crab cake sandwich, etc. Baby was happy and quiet. Joy.

I went to the bathroom and just after I came back, Bob starts giggling.
"What?" I ask, smiling, wanting to share the joke.
"My arm is numb." Giggling and shaking his head.
"Your arm is - does it tickle or something? What's so funny?"
"I don't know. My arm is numb. My left arm."
"Well, that's not funny. It's numb?!"
He pokes it and gives it a swing, smiling broadly.
"Bob, seriously! That's very weird. Quit laughing! Did somebody give you drugs or something while I was in the john?"
Shakes head, chuckling.
"And what the fuck, wipe your chin! Is your FACE numb too?"
"Heh heh heh, yeah, it is..." Smears crab cake around chin vaguely.
"Your FACE is numb? Your FACE is numb. Ok. Ok really, you're freaking me out. It's not funny. This is inappropriate euphoria. I'm going to call 9-1-1 in a minute here, quit it!"
He looks contrite, but still smiling impishly.

I get the check, I get our stuff together, I say, "Time to go." He just sits there.
"What is the matter, Bob? Stand UP." He gestures toward the floor, I look under the table and he has removed his left shoe.
"Put your shoe back on." Through gritted teeth.
He shrugs, smiling shyly.
"Do you need... help?" I almost whisper. This is when the first cold chill passes into me - my god, this is my husband, this is Bob and we have a little baby and I'm not working and I'm going to have to put his shoe on his foot for him. What if it were like this?

So I put his shoe on for him, gather the baby and his work bag and my bag and we walk into the bright sunlight. I have the brief thought that the sudden extreme change in light might really fuck him up, like he could fall down and start foaming.

And I don't know what I was thinking, I didn't head us straight back to the car, I walked us around the block. He walked, he skirted obstacles, he looked fine, but I was quizzing him.
"What's today's date?"
Shake of the head.
"Who's your mayor?"
"O'Malley." With an effort. If he had said Guiliani I thought it might have told me something, what I don't know.
"What's the baby's name?"
Nothing. Trying. Shake of the head.
"What Is Your Son's Name?"

I get us to the car. I help him in. I strap the baby in. My plan was to get him to Johns Hopkins, where our friend Jules is an Emergency doc.

I call Jules on my cell phone. She's at work. I tell her husband Leslie what's going on and he tells me to page her, which I am reluctant to do, I didn't want to interrupt her while she was doing her legitimate doctor work. Leslie gets ahold of her and she calls us right back.

Julianna says, "Call 9-1-1 right away. Tell them he has acute onset altered mental status. They will guide you to the nearest hospital. Go there RIGHT AWAY."

She didn't scare me. I knew it, I was there. I had already asked him his Social Security Number, I was thinking that while he still could talk a little I should get that, they would need it at the hospital. He worked hard on it. He told me the first 3 numbers, and the next two are the same as mine, so I said "Just the last part."

He told me, "effluent Venus hunger delta high fishtank bird fever pencil - " until I halted him gently. "Ok. That's fine. You can stop." He looked at me gratefully, and apologetically.

The 9-1-1 guy guided me landmark by landmark, exit by exit, to North Arundel Community Hospital. At one point he said, "You should see a burned-down chicken place on the right," and I said, "Sooner or later, all chicken places become burned-down chicken places, don't they." He said, "Yes ma'am. Now you'll see a Safeway coming up."

He called ahead to the hospital, so I drove straight into the ambulance bay. I got out, got the baby out, we all walked into the E.R. Bob carrying his briefcase. The nurses craned around us looking for the patient.

I told them, "This is him," and when the nurse tried to get him to sit on a gurney, Bob kept stepping around following her. It was almost funny, like Harpo Marx. He looked so NORMAL.

I was a little worried that when they assessed him, he would be normal, and only I would know that something TRULY REALLY BADLY FUCKED UP had just happened.

He got a CAT scan immediately. No clot, nothing. A doc asked him his name and stuff, he did ok. I was despairing.
Then the guy held up a pencil and said, "What is this?"
Bob shook his head amusedly, like he didn't understand the question.
"What do you call this?"
He said, "You mean what is the name of that?"
"That's right. What do you call this thing?"
Bob said, "Well that is an arble flarble natchitochez. Is that what you're asking?"
The doc said, "Yes that'll do."

He was admitted, of course. I called everyone I knew, I needed help with the baby. Good friends with small children of their own leaped to help, came to the hospital, took care of baby Big Man, stayed as long as I needed that night. Jules and Les showed up and Bob looked at them with a friendly smile. "Hi! What are you guys doing here?" Didn't know their names, was pretty sure they were friends of mine somehow. Guess he forgot the funny monologue he did into the video camera at their wedding.

In the night sometime I took the baby home and we slept in the big bed together. Did I cry then? I think I was too terrified to cry. I'm crying now though.

The first day he was in the hospital he slept almost all day. His brother Joe came up from Virginia. Mom had the baby. I was shell-shocked, vibrating with dread.

The second day he was better. I saw The Scramble for Africa by Thomas Pakenham, a classic on African history, 738 pages, at the hospital's book sale, and bought it as a joke - ha ha, while you're on your back a little light reading.

I started negotiating with insurance. He had just started his job with Baltimore City and wasn't on their health plan yet. And as it turned out, his health benefits from his previous employer, New York City, ended the day before his brain crapped out. I had to COBRA the previous coverage, but nobody would give me the form - it had to be done in person. Or it had to be done by him and only him. Several 45-minute cell phone conversations over the course of several days. Me faking weeping into the phone, "My husband CAN'T talk to you himself - he is LYING in a HOSPITAL BED!" Eventually we got all the bills anyway. Over a hundred grand, and I had to force the insurance company to pay them one by one. Took years.

Bob was in the hospital two weeks. TWO WEEKS. They gave him an MRI, an MRA, EKG's, an EEG, an echocardiogram, tests for Lyme disease, blood sugar, a PET scan, Christ knows what. I drove like a very careful maniac back and forth from the hospital to my mother's house, to my house. Picking up the baby, dropping him off. 45 minutes between each of these places. I would try not to speculate, and then I would force myself to speculate. I would think up things to test him on: the names of his 9 siblings, the countries of Africa, multiplication, current events. I would pound the wheel with my fist. "God Damn It You Will Be FINE."

My cell phone in my lap all the way. Back then my ringtone was Bach's Toccata and Fugue in D minor, so every time it rang it was like I had Dracula riding shotgun.

Bob's sister Mary is a physician, so she was my main family contact. She relayed information back to the other 8 kids and to his mom and aunts.

Bob's cousins helped out with the baby - while he was at their house, he learned to walk.

Jules came to North Arundel Hospital I don't know how many times to talk to the doctors and to check on us. She showed up wearing scrubs after her long shifts at Hopkins. I understand medical jargon pretty well, but the information that she could get as a doctor wasn't even on offer to me.

Various theories - a siezure. Not a stroke. Lyme disease. Meningitis. Migraine. Eventually he was sent home. He was sent home wearing a dozen electrodes glued to his head so that the neurologist could get a "walking EEG" - a sample of his normal brain functions over a 24-hour period.

I took him back to the hospital to have the electrodes taken off, and when I left the room he said to the EEG technician, "Um, my arm is numb."

They left the electrodes on to record whatever was going on and then wheeled him back to the emergency room. When I saw him and he told me what happened I said, "Ha. Funny." When I realized he wasn't joking I - well, I became angry.

He was getting a headache, and the longer we waited in the emergency room the worse it got. Eventually they gave him Demerol for the pain, and sent us home.

45 minutes later, I had to support him as we walked into the house. This couldn't be right, his feet were floppy and he could barely speak. I called the neurologist who said, "Come back." Fuck, why not.

Back at the hospital, we sat in the E.R. waiting room. Friday night and the place was packed. Joe arrived and waited with us. Bob could barely sit up. We got him a wheelchair. He got cold - a reaction to the Demerol. I got him a blanket. He kept shivering; I piled on more blankets. HOURS passed. He would occasionally just say, "Shit." As if he'd forgotten something. I would ask, "What is it?" and he would murmur, "Hurts."

Finally. He is given a morphine drip for the pain. We have this great nurse from Nigeria, and I test Bob's brain by quizzing him again as the morphine begins to bring him back.
"What's the capital of Nigeria?"
"Lagos," Bob sighs.
"I'm afraid not," the Nigerian guy says, but before he can get the words out Bob raises a weak hand.
"The administrative capital... was moved to Abuja... but most people... still live in Lagos."
I guess I've never been prouder of him, the big geek.

Someone decides that the only test not yet done is a lumbar puncture - a spinal tap. They bring in a huge shining needle and Bob bends over the bed clutching a pillow. I hold his hand, and tell him I don't mind, it's only fair because he had to watch my epidural. Oh, that needle went in far. But I saw the clear fluid filling up the chamber and I knew that was good.

His spinal tap had an elevated white blood cell count - a sign of infection. My doctor friends all said, "Ah, meningitis." Meningitis can cause seizures, so it was already a possible diagnosis. Meningitis is a virus that you can get from contaminated food - food like the crap you get in the filthy delis around City Hall if you're overworked and only have 20 minutes to pick up lunch. You get meningitis from some asshole who didn't wash his hands and then you get over it, like a cold. Meningitis was my favorite fecal-oral virus that spring.

The neurologist brings in an infectious disease guy. He says, "But this is a healthy man. Look at him, he does not have meningitis." When pressed, he says, "It would be very unusual for this man to have meningitis."

I nearly screamed. I believe I said (or maybe I've said it in my head so many times since then that I think I said it), "This is a healthy 37-year-old man who forgot how to speak one day. We are IN! the REALM! of the UNUSUAL!" Spitting the words. I practically begged him to tell me it was a virus and that it was over.

Another day or so in the hospital, and Bob finishes The Scramble for Africa.

We go home.