Sanctuary of Asclepius

James and I took a trip to Turkey in the late 90s with our friend Kevin.  During our visit, James was the first of us to become extremely ill.  We ended up having to hole ourselves away in a hotel in the town of Bergama (ancient Pergamon) for a few days while James recovered.  Kevin and I sat on the edge of the bed keeping vigil while James slept twisted in a white sheet through the heat of breaking a fever. We survived on the kindness of the owners of the hotel who brought in a doctor, antibiotics, and homemade soup. I discovered by observing the cook in the kitchen how to make an Ayran (Turkish yogurt drink) from scratch. In our guidebook, we learned of nearby ruins of a sacred spring called the Ascelpium, after the Greek god of medicine.  The three of us walked to the site and James bathed his head in the waters to purify himself of his recent malady.

I was thinking of Heraclitus of Ephesus on the subway ride home today after my visit with James. I mistakenly recalled that the Ascelpium was in Ephesus, which we also visited, but after looking through the photos of our trip, I realized my geographical error of memory! I thought it would be nice to tie in the healing of the sacred spring with Heraclitus's river of flux but it was not to be!  Heraclitus believed that the logos (law or principle) gave order and rationality to the world in a way that balanced the instability of appearances.  James is living in the center of that world of flux in which the logos is rather nebulous.

I left work early today so that I would have the opportunity to meet with James's psychologist and witness his physical therapy session.  I had concerns about James's possible homecoming to an entirely new apartment and what effect that would have on his psyche/cognition.  James is working hard every day with the single goal of coming home to Imogen and me and I felt if he found out we were moving, it would interfere with his rehabilitation. I also felt that the possible disappointment and confusion James would experience by returning to an unfamiliar setting might cause delay in his recovery. His psychologist agreed with my concerns. She explained that patients with brain injury such as James's temporal lobe infection often have an easier time of drawing from the past and feeling confident in recognizing the familiar--the short term is problematic. She discussed the idea of the move with the physical therapist and their feeling was to wait on moving to a new apartment. It is too soon to know how James will recover with regard to his motor skills but we may feel confident that his brain will not be ready in the same way upon discharge. In other words, James may have the capability to climb stairs assisted but he definitely will not have everything required to grasp his new life.

I am happy to wait despite my stronger feelings of wanting to be organized in a manner that attempts to foresee obstacles.  It seems slightly chaotic for me to wait until more weeks have passed leaving less time in the event I need to find an apartment but I am throwing myself into seeing the optimistic side of things which works against my nature (worst case scenario girl).

James wanted to write to me immediately about the "punishment" he received last night.  James's version of story was that he touched the tube to his trach and that the nurse came in and placed a glove on his hand, against his will. He wrote, "I was pissed off."  I looked over by the window and the "glove" was actually a very soft mitten that felt like a stuffed animal in the shape of a huge paw. I put it on and kind of liked it--made me feel as if I were a giant, plushy cat.  I explained to James that it was not punishment but protection--similar to the little mittens we placed on Imogen when she was a baby and was scratching her own face with her fingernails.  James seemed slightly skeptical of the analogy. He wanted to hold onto his idea of punishment.

Later in the afternoon, the nurse came in to check on his medication and she told me her version. It was completely different and as she told me, James's eyes were very wide and he was grinning, looking a little sheepish! She said that he repeatedly tried to take off the tube, pulled at the trach collar (a band of material that keeps the trach in place around his neck) and pulled the blood pressure monitor off of his finger. They have a night camera in his room because I warned them upon his admittance that he might attempt to pull things out at night.  She had to visit him repeatedly and ask him to stop or she would have to put a mitten on him but he would not listen. She then turned to him, in this very motherly way and said, "I made you promise me you would not do it again, didn't I?"  He looked up at her with those big, innocent blue eyes and smiled. The nurse laughed. She told me, "He stayed by his word when I finally made him promise!"

James was complaining less about the pain but it is inevitable that he will ache because of regaining his muscle tone as well as the existence of the trach tube itself.  I found out today that the trach tube causes patients to favor one side on their neck which really torques James's body into discomfort.  He asked me to readjust him in his chair between sessions today. I leaned in, placed my arm underneath his torso to shift his weight, and then, while I bent down to move him over, he kissed me on the cheek!  The rascal!  I stood upright and said, "Did you just kiss me?" and he smiled, trying to look innocent.

During physical therapy, James walked with assistance, on the double bars and with a tall walker that was placed under his arms sort of like a reading stand or podium.  It completely exhausts him but he is initiating his own movement in both legs. The occupational therapist told me during today's session that she is really impressed with James. She specializes in brain impaired patients and she finds James's progress over the past three days pretty remarkable.  She set up an exercise for him today while he was sitting in his chair involving simple movement of his arms and arranged a towel on his desk thinking she would have to pull the towel, with his arm on it, to start the movement. She was shocked that he did not even need the towel because he could lift his arms on his own.  Everyone is pleased with his progress.

There were more problems with the health insurance today but I am taking care of it.  James is being reassessed every two weeks in order to continue with his therapy.  The team believes it should not be a problem to continue because usually therapy is not extended for those that do not show progress and James has been moving steadily forward.

He had a slight set-back today with strange leg movement on his right side. It might be a side-effect of the meds so we are keeping an eye on it. It was something that I noticed immediately and brought to the doctor's attention.  I thought that I would be able to take it slightly easier now that he's in rehabilitation but it is a similar situation in that I bring knowledge of James's past to the team and my observation is keen with regard to subtle changes with him. I also noticed that his right eye was bloodshot in the corner.  Even the therapists working with him did not notice these things--their concentration is elsewhere so it's important that I am there to see the whole person.

I will also be James's caregiver when he is discharged and the therapists are already teaching me things that I may do--with regard to shifting his weight, giving him the proper stretches, and assessing his alignment.

Time for me to sleep now!  I left James snoozing in his chair today.  His bandmates, Charles and Paul dropped by last night for a visit. James told me about it this afternoon. He wants to play music with them in his hospital room!  I asked James if he is ready for visitors. He does not answer this question and I am not sure why--I wonder if it is the ataxia in that he does not understand the question or how to answer it.  I will ask again tomorrow and those that would like to visit, should think about coming after 5:00 in the evening. James will be in bed and may be tired but you all know what a social man he is--he will enjoy seeing people briefly, I imagine.  I think I should also warn everyone that he may not know who you are but he's always happy to meet people!

I do not know how to coordinate this though. It's too difficult for me to be gatekeeper but I also would not want several people visiting him at one time and overwhelming him. You may send me an email (jenniesheehan@gmail.com) if you know the exact date and time you would like to visit and if I receive two conflicting requests, I will connect you with one another to schedule it, how about that? We could just let the flux of life play itself out and in the event that you visit James and someone is already in his room (besides me), then perhaps, if you would please depart and wait for another opportunity. Either way, I know that all of you are sensitive to James's needs at this time and will respect his space to heal. All visits would have to be in the evenings because he's in therapy until approximately 4:00 in the afternoon and then, there is a transition in which the nurses take care of changing him and getting him ready for bed.

Weekends have less therapy scheduled but again, I do not know the schedule until I arrive that day.

I would like to remind everyone that the closing reception for the silent auction benefit at the 92nd Street Y will be held tomorrow evening at 8:00 p.m. (3rd Floor Hallway Gallery South Building). I plan on dropping by after visiting James and before heading home for the evening. Perhaps, I will see some of you there!

Love out to you and hoping we are able to remain in our little oasis in Greenpoint, Brooklyn.