The Smile is Back

James was so bright today, despite the fact that his sleep log shows that he did not drift off until 3:00 a.m. and woke at 8:00.  He was all smiles for everyone and spoke in a more relaxed, flowing, conversational manner.  When I entered his room, I saw on his schedule that he was having physical therapy and noticed a pad of paper on his bed with a drawing.  I decided to look at the drawing later.

I enjoy watching James in the gym. It is usually a mad dash from my office to arrive uptown in time to catch the tail-end of his session with the PTs.  He was lying on his back on a padded mat table and I dropped my face directly above his to say hello. James smiled up at me but then made a "Phew" face to show how exhausted the therapy had been and said, "It's been a tough day."

His PT had him stand and walk with the tall walker.  He is quite adept at moving his legs now although, he favors his right side and leans heavily on the right arm.  Nehal is quick to correct him whenever he starts to let his left shoulder droop and his neck starts to bend over toward the floor.  I remind him too, "Head up, look at me, eyes at me!" as I walk backward in front of him.  Whenever he reaches his limit, James opens his eyes wide and looks slightly stunned.  Nehal is petite and appears rather diminished next to James while he is standing and the second that James has that stricken expression on his face--she cannot see him because she's stuck somewhat under his shoulder area, looking at the alignment of his midsection and feet. If James is silent and she is concentrating on his body and does not peer up and see his face, she has no way of knowing that he is struggling other than his posture starts to crumple.

I said, "James, are you feeling tired?" and he nodded. Nehal guided him to sit on his wheelchair that was carefully pushed behind him by another PT in case he became tired or dizzy and needed to sit down.  Nehal said, "James, you have to tell me how you are feeling because I am not looking at your face!"  James has accustomed himself to being quiet but he's entirely capable of speaking now.  We have to encourage him to be more vocal.

After PT, he had a session with his speech therapist.  The main therapist went off to find the answer to my questions regarding aspiration and Friday's chest X-ray so the young resident went over some cognitive questions with James instead, which made the conversation a dual purpose exercise.  She asked him to explain two similarities and differences between painting and photography. I had to stifle my guffaw at such a loaded question (she was picking cognitive questions from a therapy book). I could see James contemplating his answer and then, he went into a little lecture on the nature of time and viewing.  He's so present on some things that it actually stuns the therapists--they do not know what the hell he is talking about because they are anticipating an answer such as "photos are taken with cameras and paintings are made with paint."

She also asked him to compare flowers planted in a garden to those in a vase. He started his answer by saying, "Well, it's all a matter of aesthetics."  I do not think the young therapist even knew what he was talking about.  She tried to guide him to the "correct" answer by saying flowers are cut and no longer living and those in a garden are planted with roots. He looked at her as if she were the daft one and I sort of agreed. James was talking about the differences between landscape architecture and Ikebana!  Ha!

The main speech therapist returned and said his X-ray looked great--no liquid in his lungs.  I was relieved.  He was allowed the reward of a cup of ice-chips, eaten while under supervision by the two speech therapists.  We three women sat in his room, silently watching James crunch on his ice, scooping the chips into his mouth with a spoon from a white styrofoam cup.  He was so gratified.  I could not take the simplicity of the moment, the pure joy of it so I burst out laughing. James said, "It's so delicious."

James drew his idea for the Disney stage set for the Jungle Book. He still cannot get that commitment he made to plan the set-design out of his mind. He explained it to me and wanted to be sure that I conveyed this message to the director of the production and teacher at Imogen's school, Lise Brown. Just as I am writing this, Lise sent me a photo of the backdrop they are painting for the show.  There is a strong spiritual connection between Lise and James--I am gladdened by it.

Whatever turned James around today (must be the making of that drawing) is such a relief to me.  He was so much more of himself--feeling a bit of optimism.  The team told me that he will not be discharged in mid-May and that they all arrived at a consensus that he needed more time with them.  It was a huge relief to me!  I was hoping that would be the case. He will be working with them for another month and will put on the robo-skeleton on Wednesday.  It is the best birthday gift to me ever.  It will make James happy to have finally given me the perfect gift. He has always felt a great deal of anxiety around my birthday because we joke, he's a bad gift giver!  He once said to me as we got into bed on a birthday night, some years ago, "Thank god it's over."  This one makes up for it all!