Allison’s Take

My wife, Allison, graciously offered to be a special guest author/columnist for our latest submission. There was also the minor fact that I didn’t remember too much at this point. Take it from here...

I was just finishing putting the boys down for just the second night in our new house and heard my cell phone ringing downstairs. I said “good night” to Miles and shut the door before heading downstairs to my phone: “Missed call – Joe cell”. I called him right back, “Hi babe. How did it go with the rug? Did you sell it?” From the other end I heard “Al, something is….I can’t….what is the….we need to call….” Just a series of short, unfinished thoughts. I actually thought my cell phone was cutting out so I started walking around the house, dodging boxes in every hallway, to find a good signal.

After hearing “Something’s wrong” for the third time I felt my heart racing and knew I needed to get to him. I grabbed my car keys (forgoing shoes in the middle of March) and jumped in the car. Joe wasn’t able to answer any of my questions… “Are you still at the rental house?” “If you are driving please pull over – I am on my way.” I think it took me a minute and a half to get to 450 Himalaya as I whizzed by other cars that were just cruising through the neighborhood at the 25 mile per hour limit. I was preparing myself to see Joe critically wounded, rationalizing that the reason he couldn’t answer me was that the man that came to buy our rug had physically harmed him.

I turned the corner and caught sight of our “old house” and Joe’s green Audi was parked in the driveway, the door open, Joe sitting in the driver’s seat. I threw the car into park and raced to him. I leaned down and gazed over his torso and legs and was relieved to not see any blood. I then looked in his eyes and saw confusion staring back at me. I began to ask the same questions to try to determine what I’d missed: “Does anything hurt?” “Did you meet the man for the rug?” “Baby, can you tell me what is going on?” Each time Joe was able to just get out a word or two…”Something’s wrong” or “We need to call Mike” or “I can’t remember…”. I touched his cheek and smiled, holding back tears. I told him it would be ok as I dialed 911 on my cell phone. He looked at me and very clearly said “Who are you calling?” I was surprised at the clarity of his question as he looked at me holding the phone to my ear and was just more confused that he had – what seemed like – a moment of clarity. While we were waiting for the ambulance I remember him looking down at his hand, holding his car keys. He looked at them with confusion, as though he didn’t know what they were for, and then gently placed them on the dash.

I then remembered that I had left Max and Miles at home asleep and needed to get someone over there. Luckily, in the 6 months we’d lived on Himalaya we had become friendly with a family across the street with two teenage daughters that often babysat the kids. Sven and Sue, their parents, are amazing people and I started looking up their home number. I asked Sven to come across to our house to get my garage door opener before heading to our new place to just be in the house until I had a better idea of what was going on. Sven and his youngest daughter Kirsty were running to us within seconds and as I turned around I saw the lights of the ambulance glowing behind them.

The paramedics’ team came up to Joe’s car to start assessing the situation. The first thing I was asked was his name and what happened. I explained the call I’d gotten and his inability to answer my questions. I was then asked if he had done any drugs. I told them "no" – that I had seen Joe just 30 minutes earlier at home before he left to meet a guy and his wife at 7pm to sell them a rug off Craig’s list.

The EMT team put Joe on a stretcher and I asked which hospital they were heading to. I realized that in addition to getting some shoes on, I would need to race home and get my wallet and Joe’s meds - not to mention making sure Sven, Sue and the girls were there with my kids. I left 450 Himalaya at 7:45pm and drove home quickly but surprisingly un-panicked. In retrospect I know I was unconsciously calmed by Joe’s composed and peaceful demeanor during the past 15 minutes and was figuring it couldn’t be a very big deal since he wasn’t in any pain or panic. There was never a look fear in his eyes – and it was a strange yet welcome sensation.

I expected to arrive at the hospital after the ambulance as they already had Joe inside when I left 450 Himalaya and assumed they would be leaving for Exempla within a minute or two. At 8:00pm I left the new house and surprisingly, as I made my way to Aspen Street, I met up with the ambulance coming out of the Country Estates development. There weren't any lights on and they were driving roughly 20 miles per hour. I was confused as to why they'd been at the 450 Himalaya address for the past 15 minutes and wondered why they weren't speeding to the hospital. I followed them while calling my sister Robyn to tell her what was going on. We arrived there at 8:10pm.

At 9pm I realized I would need to have someone take over at my house for Sven and his family. Robyn suggested that Heidi, my 22 year old sister, could come to the house after getting off work so she took over the babysitting duties while I stayed with Joe.

The first two hours in the Emergency Room, until about 10:30pm, were very confusing for everyone. Joe was alert and in no pain. When asked his name, birthday, address and today’s date he gave perfect answers. When asked who the president was he replied “Olama”. When asked what he had for lunch he said “Chicken sandwich”. Then in response to “Where did you eat lunch?” he said “Yes, I also had chips and a diet coke.” No matter how often he was asked where he’d eaten lunch, he could not clarify with a location.

As the questions got more detailed Joe started to ask, after every question, “What is it you’re asking me?” or “Can you say that again?” I believe it was his brain’s way of strategically buying a little time, letting the question sink in and offering a few extra seconds to search for the words to answer. Sometimes it worked. Most often after the question was repeated he would say “I’m sorry, I don’t know what you’re asking me.”

Although Joe found it almost impossible to answer questions, interestingly, he was totally able to initiate thoughts and get them out with almost perfect speech. He was very concerned about me reaching Graham, his Crispin Porter teammate, and was able to clearly and concisely tell me to call him to explain he couldn’t pick Graham up the following morning for their flight to Seattle.

Blood had been taken and results showed no drug use. He had been taken for a CAT Scan and there was no bleeding on the brain. By 10:30pm it was clear to the hospital staff that Joe’s condition was even more of a mystery. Around 11pm a doctor who introduced himself as “Ben” came in dressed in jeans, a plaid flannel shirt and leather boots – looking like he’d walked in straight from a hike. He introduced himself to me and Joe and sat down on the rolling chair. He asked Joe the same initial questions he’d already been asked by two dozen doctors and nurses prior and then said “Please repeat after me….A E I O U”. Joe asked him to repeat the question and after the second pass replied “A E I O”, forgetting the “U”. Ben said, “Repeat after me….No ifs ands or buts.” Joe again asked him to repeat it and his response was completely garbled. Joe, realizing he wasn’t saying the correct thing, tried again and Ben stopped him by putting his hand on Joe’s arm. Ben then said, “Joe, I believe you may have suffered a stroke tonight.”

In this moment my body felt empty. The calm I had been feeling changed to a sense of disbelief, bewilderment and fear. Joe didn’t understand the gravity of Ben’s comment and looked at me for clarification. With tears in my eyes I went to him lying there, grabbed his hand and said “Baby, you’re having a hard time with your language and they’re going to do some more tests. They think something might have happened in your brain tonight. Everything will be fine.”

My sister arrived shortly afterwards and she was the first person I shared the news with her. The word “stroke” felt erroneous and impossible. Since his open heart surgery he’d been seen by doctors consistently, was taking 2 baby aspirin daily, was in great shape and DAMMIT, he was only 38 frickin years old!!

Around midnight Robyn and I followed the nurse as she rolled Joe down to get a carotid ultra sound. By looking at the two large arteries in his neck (called carotid arteries) which supply your brain with blood doctors can tell whether plaque has narrowed them. The plaque can slow down or block the flow of blood through the artery, allowing a blood clot to form. A piece of the blood clot can break off and get stuck in the artery, blocking blood flow to the brain and thereby cause a stroke. The ultrasound showed no plaque build-up.

By 1:30am Joe was admitted to Exempla Good Samaritan Hospital and moved into his room on the 4th floor. Robyn said “goodbye” to Joe and said she’d wait for me out in the hall. I sat on Joe’s bed and looked in his eyes. He said “What is going on?” I said, “Honey, they think you might have had a stroke tonight. Your brain is not responding normally and they are going to do some more tests to help figure out what happened.” It was a tough “good bye” for both of us. I knew Joe was exhausted and needed sleep but was so confused about everything that was going on around him. I told him I’d be back by 7:30am the next morning.

After a few hours of sleep I showered and headed back to the hospital. I briefly spoke to the beautiful nurse who resembled Angelina Jolie (really!) named Trissi before going in his room. She told me Joe was taken for an MRI at 2:30am after I’d headed home. Results were still pending so I went inside Joe’s room to say “hi”.
He was awake and, although tired, he was already analyzing how his brain was – and was not – functioning like normal. I asked him to read the sign on the wall which had the 4-digit number for reaching the Kitchen on it. Instead of saying “Kitchen” he said “mitchek”. He caught himself immediately and said, “Ah, why did I say that? I know that’s not how you say that word”. I asked him to try again and he again said “mitchek”. After a third attempt he asked me to say the word and while looking intently at my lips saying “kitchen” he practiced a few times and finally said “kitchen”. It is a very distinct memory for both of us, him re-learning the word “kitchen” – just one of a million words Joe has had to re-learn…much like learning a new language where the rules, phonemes (meaningful sounds), syntax, and grammar need to be taught along with vocabulary.

For me, this first morning after the stroke proved to be the most relieving and most scary of my life. I was so comforted that Joe was showing great improvements already and – unlike many stroke patients – that he was not paralyzed. However, I was so unsure of how much of my husband that we’d lost. How much would his brain heal? Would he ever be able to speak effortlessly again? So many people have asked how I got through those first few months without going crazy. I took it day by day – and sometimes minute by minute. Joe was in there – we just needed to be patient enough to have him come back to us in his own time.

DID YOU KNOW?

Stroke is the third leading cause of death in the United States. Over 143,579 people die each year from stroke in the United States.

Stroke is the leading cause of serious, long-term disability in the United States.

Each year, about 795,000 people suffer a stroke. About 600,000 of these are first attacks, and 185,000 are recurrent attacks.

Shattered

The scene on this chilly early spring night transcended from me alone dimly lit from above near the garage and sat still momentarily becoming aware of the occasional neighborhood dog barking. I didn’t contemplate, I didn’t think at all and that is the secret that I can recognize in retrospect. I was content. Complete tranquility. Happy. And this didn’t change right away. From a sleepy, non-descriptive suburban development, home, driveway and life was grabbed by a lose thread of a life and unraveled it as if it was pulled unexpectedly torn on a rusty nail while brushing by a fence in disrepair. But I didn’t see the mess it created. Despite the cacophony around me I absorbed it, one stimuli at a time…conscious, aware and more curious than disconcerted. One ambulance, 4 EMT first responders, two police cruisers and 4 cops. Allison shared what she knew which was limited. She found me sitting there in the car and unable to get more than one word at a time out of my mouth.

One of the EMTs kneeled in front of me. He asked me a number of questions:

-“What is your name?” No response from me.
-“Where are you? No response to me.
-“What is your birthday? No response again.

In each case I tried to answer. I really did but the words wouldn’t come out. The EMT stood up to speak with Allison and as quickly as he was in front of me, I forgot he ever existed. And then I saw my neighbor, Sven. Sven and his lovely family are from South Africa and we were lucky enough to have their teenage daughters often come to the house to babysit. Sven and his youngest daughter, Kirsty came across the street and passing the tumult that was impossible to avoid in the quiet Wednesday evening. Kirsty followed closely behind Sven to see us while staying out of the way of the team. And while I was watching Sven’s face I was conscious of the fact that the only things I was looking at, hearing and understanding was Sven. Not Allison, the cops, the EMTs or even Sven’s daughter who stood right next to him, holding his hand. Sven hadn’t uttered a word. He stood maybe 25 feet away but it was like I had a camera lens of a movie that zoomed in on Sven’s face. His countenance of concerns, his wispy, thinning front hair, the back angling brow and 1 day’s worth of stubble. And I was completely present with Sven without a word from either of us. As focused and locked-in as I was with Sven that moment passed fluidly into looking at Kirtsy. Like while looking at Sven and now again with Kirsty, everything else seemed to lose its fidelity; Sounds, depth, smell, touch, texture and peripheral vision. But what was lost in the moment’s context of all five senses was made up by making the subject insanely acute. Like looking through a portal using High Definition and headphones with surround sound. But the screen was not huge like an I-Max…. it was small through the looking glass.

The next scene panned to the EMT again and now I was being helped into a stretcher. I was wrapped in blankets and secured before they rose me up on the stretcher. I was aware I was going into an ambulance. Allison looked at me, kissing me and told me she would meet me at the hospital. “They’re going to take care of you. “I’ll take care of you.” And with that I was put into the back of the ambulance. The doors closed behind.

Inside the ambulance everything was heightened. The lights were brilliantly blinding. The open and closing of cabinets were deafening. The ripped sound of a new IV was heard loudly inside my head, not just outside. One tech began the IV while another wearing latex gloves and looked at me closely. “Mr. Salvati, who is the president?” I focused and I looked deep inside the irises of the eyes of the tech and his over gelled hair and I confidently said to him, “Omama.” And I heard it myself too. “Omama.” “Why did I say that?” I was thinking to myself. He asked me a couple more questions and I couldn’t get another word out of my mouth. In my head “Omama” kept echoing inside the cavern of my head, unable to focus on anything else let alone answer to another question. And then I stopped listen to my mind and came back to listening and focusing on what the EMTs were saying and doing despite how loud it all sounded to me. And next what happened was the precise moment that my calmness was abruptly, rudely ended. The EMT’s who were speaking to each were as if the three of us weren’t in the same room let alone in the back of a moving ambulance. That was rude enough but I never expected to hear one EMT to say out loudly to another, “This guy must have been doing a lot of drugs.” I was enraged but couldn’t speak a word and with my right hand I made a fist and hit my thigh. I did it again as if to protest the indictment, implication, possibly endangered me and worst of all he shattered the closest I’ve ever been to complete tranquility.

What happens at the hospital comes next…


DID YOU KNOW? On average, every 40 seconds someone in the United States has a stroke.

Something is Different

I knew I forgot something… call Allison. She's gonna kill me.

So knowing that something was different and I was unable to close the garage, I sat in the car’s driver side in the driveway. Keep in mind that I had no plan on driving. It wasn’t that I was scared in fact the mere thought of driving home didn’t even enter my mind. I never lost conscious. Most stroke suffers lose conscious, waking up (if they do) after sometime and often have a blurring ephemeral return back to reality albeit likely altered. If they are lucky they will recognize someone looking above them with a combination of smiles hidden by their concern. Others wake up attached to tubes, leaders from EKGs, IVs and if they made it this far the unmistakable wafting mixed of scents of hospital smells; rubbing alcohol, stale flowers 24 hours from expiring, hospital food in various states of consumption all combined with the unique various inmates/patients mixed with their own ailment. Imagine that for a moment.

One minute you’re in a Starbuck’s getting your latte on. You ask the barista for a grande. You’re on the phone with a colleague about a deadline which just went sideway. In your mind, working in the background much like a computer, there are a dozen other things to process, consider, choose, decide, procrastinate, plan, worry, and look forward to. You’re processing what your colleague is telling you. You consider talking to your colleague and asking them to call the client to have a meeting. You choose about whether you should get a blueberry muffin at Starbucks or get something on the way to the airport? You decide to refinance the house now because interest rates have gotten pretty low and we should refinance now. You procrastinate getting your driver’s license renewed because who the hell wants to go to the DMV. You plan for a vacation 6 months ago. Where should we go? You worry about whether or not the economy is going to go into a “double-dip?” You look forward to seeing the kids when you get home from your business trip. But at the moment of the stroke, it all stops. But if it was even possible, I digressed more than usual.

While sitting in the car, looking down at my iPhone, and then looking up, I had forgotten why I was there, in my car, in this driveway, of this house, in this state, at this time, of day of this month or year. So even more befuddling to me was why Allison had suddenly been kneeling down in front of me in the driveway of our rental house. I did recognize her and then after a few moments I vaguely remembering something about her talking to me on the phone. It would be accurate to call it a “conversation” because at the time, on the phone I was unable to get past 1-2 words let alone a coherent thought, feeling, expression or an explanation. Later I would understand that Allison guessed on where I was at the time of the stroke. Allison had to guess where I was and which way she drove to find me. She had no idea if I went to the rental, if I was driving, had I stopped on the road side? Did I drive off into a ditch? While the kids were blissfully ignorant and asleep while what was occurring Allison jumped in her car a started to drive following instinct and instantaneously calculating where I might have been and the route I might have taken. She was right.

She was wearing blue pilled sweats, Ugg boot knock-offs and a face that combined urgency with incredible calm। And so here I was. I had no pain. But I did have this sense that my peripheral site was not blurry but was not considered in my mind. Ambient sounds were all muted. Allison pulled into the driveway and kneeled upon an icy driveway and looked straight in my eyes.

Allison: “Are you ok?”
Me: “I’m…”
Allison: “Did someone hurt you?”
Me: “Something…” “I…”

And this is when I started to understand that something was beyond a “normal” experience. I understood most of her questions. And I thought I understood the answers to her questions. At most I could get one word out of my mouth. And often nothing came out of my mouth at all. I knew Allison was calling 911 and this was the first time that more than one word in a row came out of my mouth.

“Something is different.” Not ‘wrong,’ ‘different.’ “Something is different.”

Allison called it in and gave my location and condition. ‘Condition’ for Allison would observe me as confused, not speaking, and I’m sure she was a little scared but….calm. ‘Condition’ for me was ‘different.’ I wasn’t scared. I wasn’t in pain. There was no past or future there was only that moment. And nothing else mattered in my mind. I was calm, and experienced a tranquility that I wish I could bottle. The tranquility remained even though an ambulance and police officers arrived with brilliant red, white and blue brilliant flashing lights along with a small platoon of EMTs and police officers. And despite all the brilliance of lights, strangers, the parade of neighbors pouring out of their front homes and moving closer, I only saw and heard was Allison. At least for the moment that was all I had.

How long would this tranquility maintain? You’ll find out soon…...