Rag Doll For Christmas

RAG DOLL FOR CHRISTMAS

ONE

"there is absolutely nothing wrong with you!"

I became old suddenly, over night. Up until then I was a spry and active seventy-eight year old, enjoying life to the full. People said I looked at least twenty years younger. "You will never grow old" they confided as if I had a magic formula. The truth is that since 1981 when I visited my brother in South Africa, I had been treated for high blood pressure. I was being monitored regularly and the hypertension kept under control by various drugs prescribed by GPs both in New Zealand where I lived for thirty-five years and in England. One of these drugs the doctor rather airily told me was a derivative of snake venom, still in its experimental stage. The anticoagulant was "purely a precautionary measure since you have a family history of strokes". My mother and her parents had died from brain attacks.

It was probably by luck more than anything else, a healthy lifestyle and a smattering of youthful genes that had kept me young. Plus of course a regular dose of hormone replacement therapy that I had taken for well over ten years. However I do admit that over the years I had had numerous major surgeries, the last of which was a mastectomy, followed by five years of chemotherapy. This oestrogen-reducing drug is commonly used for breast cancer treatment. It also reduced my libido that had been very strong and enabled me to enjoy a full life.

In spite of a fairly rocky marriage, ending in divorce in 1980, and bringing up my family of teenagers alone, I had kept a fairly optimistic and liberal outlook on life. I obtained a Bachelor of Arts Degree when I was fifty seven, became involved in the Women's Liberation Movement, was active on various voluntary committees, set up my own painting studio and exhibited regularly in art shows. I worked at the University of Canterbury Student Union, developed an installation in the Christchurch Botanic Gardens, New Zealand, celebrating pure artesian water and had numerous trips overseas to visit family and friends in England, South Africa and Canada.

I also created a cliff-side garden using a broken grubber to chip goat tracks out of the volcanic rock. I wrote poetry for a Women's Art Collective, and ecology articles for a local community newsletter. I went for long walks with my dog and looked after five cats and some goldfish! There was still time to decorate my home and watch television or read a book, have lunch with friends or simply lie in the sun on my sundecks that I designed and my youngest son helped to build.

When asked by my doctor what I had been doing over the year he exclaimed that I did more than most people packed into their whole lives. I seemed to thrive on stress. I worked to a five year plan, ticking off the steps I took to reach my goals. My last great achievement, when my sons had married and had children of their own, was packing up my household goods and returning to Dorset, England to live in a two hundred year old cottage, in order to help my daughter bring up her family. They needed a grandma, and my sons had their father and mothers-in-law so did not really need my input any more. I have been here now for almost thirteen years.

In Dorset, I have remained active in the community, belonging to the Women's Institute, on the

committee, creating a mosaic at the local school, and helping to design and stitch a 700 th anniversary tapestry for Dorchester. I also was involved in designing and stitching a 2000 celebratory banqueting cloth for the W.I., as well as taking part in church activities, exhibiting my paintings and designing and planting a cottage garden. I have made several trips back to New Zealand taking grand children with me on three occasions.

The last trip was in 2007 to Queensland, Australia to visit my sons and families there. Unfortunately I caught Asian flu, so was not my usual effervescent self. In between I have enjoyed some delightful relationships with various men, but never wanted to live with anyone again. So what happened to change all that?

As I said before I made regular visits to my doctor to have my blood pressure checked. I also drew his attention to swollen ankles, a dry chesty cough, and the odd occasions when I lost consciousness.

At one time I had a thrumming pain in my ear with the loud noise of my heart palpitating. I found increasingly that I got very breathless trying to keep up with the family out in town or on walks. "You go on ahead if you want to go on a route march!" I would call out from behind. "I'll catch up with you later". The GP treated each symptom separately, listened to my chest, prescribed an antibiotic or some other remedy and dismissed it all as old age. At no time did he put all the symptoms together.

Incredibly I now found I got out of breath just walking across the room, getting dressed in the morning or, amazingly, washing my face. I could not breathe lying flat in bed and had to prop myself up with several pillows. I sat slumped forward with my chin on my hands, elbows resting on my knees. I reminded myself of my mother when she was almost ninety. I noticed I was walking at snails pace, dragging my feet as if they were stuck to the ground. I bumped into things, and embarrassingly got my foot tangled up in a display table at the hairdressers. I found it hard to concentrate on what was being said to me, getting completely lost in the hospital corridors when going for tests. I even caught the wrong bus home, which is something I had never done before.

When I walked any distance I experienced the most painful stitch-like pain beneath my ribs on the right side of my body, right through to my back. Nothing seemed to relieve it. What on earth was happening to me?

Once again I sat in the doctor's surgery. The results of various tests had come back. Xrays, blood tests for this and that, all had negative results.

"There is absolutely nothing wrong with you!" my doctor said confidently.

"Tell you what then, when I collapse, you can find out what it was!" I retorted.

He listened to my heart under my arm on my left side with his stethoscope.

"Mmm! Have you ever had an ECG? An electrocardiogram?"

"No, never - even though I have had such a lot of surgery, I have never had my heart monitored!"

"Perhaps you had better have one then. You may have a very slight murmur, but nothing to worry about" "Good idea!"

An appointment was made with his nurse for the test the next week.

I was then asked to fill in a form to say what hospital I wanted to go to for an echocardiogram. Since I do not have a car I chose the nearest one. I was expected to ring up the Appointments Agency to make an appointment. The hospital of my choice would then confirm by letter the most convenient time for me to come for the test. It seemed to me to be the most long winded waste of time ever devised. It was something to do with the idea that the patient is in control of their own treatment.

Hard luck if they made the wrong choice. No one else could be blamed. The only problem was that very few people when really sick have any idea of the reputation of any hospital or consultant. All

they want is to be treated as soon as possible. It also covered the back of the doctor who may have advised the patient that they needed treatment. It was in the hands of the patient to choose to have it or not.

Some days later I found myself lying on an examination table with a very sweet cardiology assistant operating a fascinating machine that measured my heart beats, and the flow of blood through the ventricles. Occasionally she would turn up the sound of the heart pumping, and on the left side it was obviously making abnormal swishing noises. When the examination was complete she told me to wait a while because she wanted to show the results to the consultant.

"This seems to be urgent and I do not want you to miss your place in the queue", she said.

She seemed to be really insistent and concerned. However the consultant said that he could not see me then. I had to go back to my doctor. "The results will be put on the computer right away. Ring your doctor as soon as you get home and he can make an appointment with the consultant".

When I returned home I rang the surgery and told the receptionist the instructions I had been given.

"Nonsense!" she said. "The results from Xrays don't come back for at least a week".

"But the results have already been put onto the computer. My doctor can view them now!"

"Impossible! Results from Xrays do not come back for at least a week" "But this was not an Xray. It was a cardiogram" "Nonetheless he can't make an appointment for you until he sees you and that wont be until next week. Ring again in the morning and we can see what happens".

She put the phone down. I rang the following morning and yes, the results had come through and an appointment was made to see my doctor the following week.

In November the Christmas season of parties and special events begins. Although I was feeling very weak and disoriented I still went to the Christmas lunches and dinners given by various clubs and organisations I belonged to. I went to church as usual and out for lunch with friends.

I even went on a trip on the Cross Channel ferry to Guernsey to view their celebratory tapestry with other members of our own tapestry group. This lifestyle was to end abruptly very soon.

My doctor swivelled his computer console round so that I could see it.

"I am not really supposed to let you see this", he said.

I read the results of the cardiogram with amazement. "SEVERE HEART FAILURE" it read.

"Why has this never been diagnosed before? It can't have happened suddenly!"

"Well it is difficult to make a diagnosis of shortness of breath. It could be so many things". He looked deflated.

"But you told me there was nothing wrong with me!"

"All it means is that your heart is not working as well as it used to" "So what happens now?"

Once again I had to make my own appointment with the hospital of my choice to see the cardiology specialist, or one of his team of experts. They in turn would contact me to make another appointment if necessary. The date was some time in January 2008. Eventually this was changed to a time in early December 2007. At no time was I advised to rest but given a slight change of medication. My own doctor had been worried in case the consultant asked

why I was not on a regular prescription of aspirin. I took it intermittently because invariably I got a nose bleed if I stayed on it for any length of time.

The consultant was a very pleasant Asian man who told me that my heart was not pumping blood as well as it used to. No one really knew why this happened. It could be genetic, a virus or the result of environmental factors. I would be given other tests and a beta blocking drug added to my medication. He would see me again in six months. Meanwhile I would be put in touch with the Cardiac Nurse who would monitor my progress. Events radically interrupted this scheme.

TWO

"do you know where you are?"

It is difficult to describe and I do not believe anyone, least of all myself, knew just how ill I really was. It felt as if my vital energy was leaking out of the crooks of my arms and from my wrists. It became increasingly obvious that I could no longer do everyday tasks without a great deal of effort and it took an hour with rests in between just to dress myself in the morning. I told my daughter and she was sympathetic. People at church were solicitous and offered their help. The problem was I did not really know what they could do. I could not think.

Even if I took advantage of their kindness, would it be something I could permanently rely on, or would it be a temporary thing? If I were offered a lift into town, I would not be able to walk far without having to sit down every few yards. Shopping would take hours, and I could not expect anyone to do my Christmas shopping for me. I was the only one who could choose what I wanted. I felt like a fraud asking for help. It did not seem like any illness I recognised.

I ordered my groceries on the Internet. It took two hours to make the choices and fill in the required data. Goodness knows what my phone bill would be like! It was the first and last time I took advantage of this service - it took too long. Besides I did not feel like eating much anyway and the food just went mouldy in the fridge.

My thirteen year old grandson was pleased with the offer of a Saturday job, and I gave him the minimum of £5 an hour. He helped to tidy the garden to put it to bed, and burn the garden rubbish in the incinerator. He got in wood for the burner and lit the fire, polished brass and planted bulbs in pots for the Spring. He helped to put up the Christmas lights and decorations and dressed the artificial tree.

Instead of giving the family individual presents, I collected things for a hamper. I usually gave a big feast with fish, cold meats, salads and cheeses, and all kinds of desserts on Christmas Eve, Continental style, and we gave each other our gifts then. Primarily this was so that I did not have to carry them up the hill to their house on Christmas Day! This year things had to be different. I just did not have the energy to plan and make the meal. The hamper was the next best thing. It was just as well because events intervened. Fortunately I had sent off the overseas Christmas cards a long while ago and the local ones were all written and waiting delivery. The overseas parcels had been sent off as well, so I could sit back and relax.

I sat in my garden room, happy and relaxed, at peace with the scene outside the French

windows. It was late afternoon and the sun was low, bringing the late Autumn colours to life against a backdrop of a black and sultry sky. There was a storm brewing. Sometimes in Summer lying back in the garden, looking at the sky with eyes slightly out of focus, it is possible to see myriads of sparkles seemingly in a chaotic dance. Lots of people see them, so I am told. The sparkles dash in different directions and sometimes spiral and merge with others.

They move so quickly it is impossible to accurately trace their movement.

These particles were dancing now in the room with me, greatly enlarged, swirling around above my head. It was the most amazing sight. The bright light sparkling at each head was like a LED light and flaring from it was an aura of chrome yellow. They were shaped like sperm, with black cilia tails propelling them along. How beautiful! Angels! I said out loud. I watched the beautiful patterns they made, like a shoal of fish, or starlings flying to roost, for at least five minutes and then they dissipated into the atmosphere. The only other time I had seen this phenomenon, but just the bright lights, was when in the 1970's I and a friend were blessed with the Holy Spirit. He had seen it too. I wondered if this was what the Apostles had experienced in the upper room at Pentecost. Tongues of Fire.

I tried to rationalise what I had just experienced. Were these sparks charged particles? Was it something to do with the growing storm? There had been no obvious sounds of thunder, nor of wind, though I seem to recall a humming sound, a hissing maybe like electricity, but that may not be so. Just a few weeks before she died, my mother had said she saw sparkling things coming down from the sky. We thought she was hallucinating. Had she seen the same thing?

Perhaps the particles were escaping from my brain? A vital energy had escaped into the environment. Whatever the cause I felt at peace and looked with wonder at the awesome display that gave order to apparent chaos.

A few days later I was sitting in my living room watching television. It was the 15 th December, 2007 and I had had quite a busy day wrapping presents and putting finishing touches to preparations for the coming festivities. I contentedly enjoyed the Christmas lights around me, the tree with all its decorations and the candles burning in the hearth. My grandson had lit the wood burner and I felt cosseted. The last instalment of Cranford had just finished, and I got up to fetch some supper. My head felt woozy and I could not hold it up properly. My left leg gave way and I found myself on the floor. I tried to get up but my left arm was too weak and would not hold me. I heard myself calling in a timorous voice for help. I thought that if I concentrated in a telepathic fashion perhaps someone would answer.

Perhaps I had been sitting awkwardly and that my leg had gone to sleep? I managed to right myself and drag myself across the carpet using my right leg as a lever, much like a baby does.

You have no idea how hard it is to drag a heavy body across the grain of carpet weave. After what seemed like hours of struggle I reached the kitchen door. There is a telephone on top of the tall refrigerator just inside the kitchen and the phone connection is at floor level. I pulled on the lead and the phone fell down on top of me. I dialled my daughter's number. Thank God there was someone at home for a change.

"I have fallen on the floor and I can't get up!" My voice sounded far away and very weak.

"Stay where you are and we will be over in a minute".

My daughter and son-in-law had experience of this type of situation with his father who was almost sedentary and always falling over. Sadly the old man had died a few months before and

they were still suffering from grief and the effects of clearing up his estate. I imagine they were saying "here we go again!" They arrived to find me propped up against the wall. My breath was coming in great gasps as if I was running a marathon. I could breath in but not out. My diaphragm was squeezing the air out rapidly, making strange guttural wheezing noises. My doctor had described it as "wheezy bronchitis". It turned out to be connected to my heart failure and was congestive. The pain in my right side was intense. I could not do it any more.

My son-in-law helped me to my feet and sat me in a chair.

"I'll get you a cup of tea!" he said. Tea was a panacea for all ills.

"Can you walk?" No I couldn't.

"I think I am having a stroke" I said. I looked at my feet. They seemed very far away.

"We will call the doctor on Monday" "I think you should call an ambulance" "We should call an ambulance" " Right now" The ambulance arrived about thirty minutes later and blocked the lane. Just like in Holby City the two medics bustled into my cottage full of enthusiasm and efficiency.

"What is your name?"

"What is your birth date?"

"How many fingers am I holding up?" Five, two, one.

"Can you lift your arms?" My left arm hardly lifted at all.

"Can you clench your fist?" Yes, I could make a fist.

"Where does it hurt?" All over but mostly in my right side under my ribs.

A medic shone a light into my eyes.

"Looks alright, could be an inflamed heart!"

"It's okay, we will put you into our chair and get you into the ambulance!"

I could hear my daughter and son-in-law talking together about who would go with me to the hospital and who would travel in the car behind. My son-in-law collected all the medications I had been taking, to take to the hospital. He had done this before with his dad. In the ambulance a medic attached me to an ECG machine that showed my heart rhythms. An oxygen mask was put over my face, a needle with two raised caps was pushed into a vein in my right wrist and a bracelet with my hospital number and name put on my left wrist. I was given an injection of morphine through the needle in my wrist, to dull the pain in my chest. A saline drip was attached to the needle through one of the caps. Then I was transferred on to a trolley with blankets covering me and strapped in. We sped through the night and in no time reached the Casualty Department at Dorset County Hospital.

I vaguely remember some nurses and a black female doctor looking me over and checking heart rates and oxygen levels. I drifted in and out of a morphine haze, the curtains in the cubicle fading in and out and seeming to slip downwards as I tried to focus. I was suddenly aware of my daughter sitting on a chair by my trolley. She had quickly brought a few things for an overnight stay while I was checked over. I told her I was alright and she could go home as it was a work day tomorrow.

"Do you know where you are?" Dorset County Hospital!

"Can you lift your arms? Not the left one at all. It felt like lead.

"Can you clench your fist?" A little!

"What is your name. What is your date of birth?"

"Do you know where you are?"

In a blur I was lifted into a hospital electric adjustable bed and trundled through double doors like a spaceship air lock, to the Critical Medical Unit.

"Do you know where you are?"

Yes - Battleship Galactica!

THREE

"the healing comes from within yourself" I felt terrible. The soporific effect of the morphine injection was wearing off. I felt cold and clammy, my breath being squeezed out by the muscles in my diaphragm in strange guttural wheezes. My heart was pounding and seemed as if it was trying to escape from my chest. I could feel and hear it flip flopping all over the place. I was paralysed all down my left side, and the left side of my face had dropped, my speech was slurred, my throat felt as if sand had been poured in it. The pain in my right side was excruciating.

A nurse came to pile on more blankets. They felt heavy and suffocating.

"I feel terrible" "There, there darlin', you are just fine", she crooned.

I tried to kick off the blankets, only for them to be firmly replaced.

"The doctors will be round in the morning, darlin'. Try to sleep now" She shone a torch in my eyes, took my blood pressure and temperature and disappeared.

I hauled myself upright pulling on the rails at the side of the bed, using my right arm. Thank goodness that I was a physically strong person. My head felt very heavy, and my stomach muscles were contracting as if I was in labour. I felt nauseous and I had no control at all except to force the air out of my lungs. My genitals felt like they did when I was menstruating or like when I was giving birth. It was hard to explain to the intern standing beside me.

"How do you feel?" Terrible, as if I am in labour.

"Have you felt like this before?" What a silly question. I cannot do this any more.

My strength was ebbing away.

Suddenly there were more consultants around me including the cardiologist I had originally seen.

"How long has she been like this?"

"Has she had a Chest Xray?"

My vital energy was escaping. I cannot do this any more.

I stood outside myself observing how strange it was that body reflexes took over in the struggle to stay alive. It was nothing to do with resolve or determination. Okay, I thought, I will just relax into it. I

cannot do it by myself. But God it was painful, either take me or heal me, but don't leave me struggling in between. Where was God in all this anyway? I could do nothing on my own. All my muscles had taken control, and I was reminded of a poor lamb that had died in my kitchen, its reflexes jumping as if it was gambolling across some distant unseen meadow.

"I cannot do it any more!", I wheezed, through my oxygen mask.

I felt hands on my shoulders.

"HOLD ON" someone shouted in my ear.

"We are here with you. Hold on" One of the consultants was busily discussing procedure with the other. A whole group was now standing inside the drawn curtains surrounding my bed.

"You are very lucky to have the cardiologist here with you" a nurse said. Apparently this man was highly respected and held in awe.

"Let me see how she is breathing. Looks like panic. Breath slowly with deep breaths" another nurse said. I cannot do this any more. I had no more reserves left. The pain in my side was so intense I could hardly bear it. The ambulance medic had said it was an inflamed heart. These were top consultants so they should know what to do. The ambulance man had given me morphine to dull the pain. I tried to explain but perhaps my voice was too weak for them to hear. Reluctantly one of the doctors agreed that I should be given a mild dose of morphine.

I sank into a fitful sleep prompted by ministrations and murmurings from solicitous attendants.

The results had come back from the portable Xray. The saline drip was removed. I was given a suppository of a large amount of aspirin, an injection of a diuretic and another heart drug. Apparently I was suffering from congestive heart failure aggravated by the drip. I was drowning! Every few hours I had a nebulizer put into my oxygen mask to ease my breathing.

I was booked in for a CAT scan to discover what kind of stroke I had had and where in my brain it was situated. So far I had not had any food or drink in case I was not able to swallow properly. I would have to wait for the Speech and Throat Therapist to view me before I could take anything by mouth. She was finally tracked down a couple of days later. Meanwhile I was not given any medication except through injection. I was taken in my bed up to the Acute Stroke Unit complete with oxygen bottle, all my notes and my personal belongings.

A pretty hospital gown was substituted for the pyjamas and dressing gown I had arrived in. Long white heavy cotton support hose were peeled onto my legs. The crisis had passed and I was propped up against a pile of voluminous pillows. All pain had gone, the Speech Therapist had said I could now eat and drink and my medications were begun, complete with a dose of magnesia to assist bowel movement! A catheter attached to a urine bag was inserted to drain my bladder.

The consultant arrived by my bed and shook my hand.

"Very pleased to meet you" he said graciously. I took his hand.

"You have made a much faster recovery than most people" he said. I smiled knowingly.

"It was not me" I said. "It was the Holy Spirit" I told him I had told God to either take me or heal me.

"Thank you for all your help. I could not have made it without you" I said.

"I had very little to do with it. The healing comes from within yourself" he said.

We smiled at each other and he left.

The long period of treatment and rehabilitation for heart failure and stroke paralysis had just begun. I had been given all kinds of challenges in my life, and now I said to God "Look what a pretty mess you have got me into this time". I could imagine the reply "I just wanted to see how you got yourself out of this one!" Well, I have a devious plan……………..!

FOUR

Inside Battleship Galactica This was the most surreal thing. I seemed to have been transported in a pod into the bowels of Battleship Galactica. The Acute Stroke unit consisted of six beds, each with their array of high tech equipment and an angle poise television set. Digital bleeps, trills and alarms continuously noised, along with flashing red lights. Most were ignored as nuisance when there were more important considerations like changing soiled sheets and making never ending notes. Male and female contorted creatures, linked to mother ship by tubes and wires, lay on piles of pillows, restless and groaning in misery. I discovered I was one of them There were two robotic hoists. One called Opera was the most remarkable contraption with arms outstretched from which a canvas cradle was hung and the patient was whirled into the air to be deposited either on a commode or a chair and back into bed. What I had not realised was that my bottom hung out of the cradle, like being "held out" to urinate when I was a child. It left nothing to the imagination and certainly any dignity fast disappeared when a male nurse wiped my posterior poking out at eye level from the cradle. The other robotic hoist, Encore, was for people who found it impossible to stand without assistance. Now that many people are overweight, such contraptions are vital. The only thing the robots lacked were strobe lights on their heads, or some sort of recognition that they were "on our side"!

"How are you today?"

A very neat and well turned out doctor with a retinue of attendants trailing behind him, swirled the curtains closed around my bed. There was a laptop computer on a stand, a lackey with the inevitable clipboard, and various other important people looking in my direction.

"I feel as if I am a Cylon linked up to Mother Ship" I said jokingly.

They did not see the joke. Perhaps they were not sci-fi fans.

I was attached by numerous wires to various vital points on my body to a twenty-four-hour heart monitor that did not work properly and kept bleeping in anguish for some reason. When I asked what was supposed to be the cause and why it was not attended to, I was told the alarm went off if there was a problem. Why the problem was never solved remains a mystery.

"Has she had her CAT scan yet?"

I had not but the doctor continued to talk over the top of me discussing various possible scenarios as to my condition.

"Can you squeeze my hand?"

No, I was unable to even lift my hand let alone close my fingers.

"Can you feel this?" He touched my left hand and then my right hand. It felt the same. There was plenty of feeling and in fact my fingers felt very sore as if they had been burned.

He spoke into a hand held recorder and swishing the curtains open proceeded to the next bed.

One of the patients was hooked up by a feeding tube to a pumping device that bleeped monotonously whenever the tube became twisted or blocked. Added to it was a saline drip that also ran through another pump with its own digital alarm system. The two together set off a chorus with the trilling alarms coming from massage air beds that slowly deflated, swallowing patients like monsters from the deep. The staff were so immune to the cacophony of noise they hardly noticed, let alone responded to anyone who pressed their buzzer for assistance. A male nurse I christened " Igor" after the character in Frankenstein wandered into the ward pushing a wheeled stand on which was a box displaying computerised statistics and data. It measured heart beats, oxygen levels and blood pressure. That was when it was working properly. Sometimes the batteries had not been charged.

Igor stood with a stoop, his palms facing outwards, and looked as if he still had his coat hanger still in his jacket. He did his job methodically slowly having worked on the ward for countless years.

"Do you mind if I take your temperature?" he breathed.

The gadget he held was a sort of box with a display window and a wand attached that recorded the exact temperature inside a patient's mouth. That was when it worked. It made a discreet bleep when the data came through. The wand was then dipped into a hole at the side of the device ready for use again. I never did discover what was in the hole.

"Just a short sharp prick"!

My finger tips were soon to become bruised and sore from blood sampling for cholesterol and blood sugar levels. The hand held device for this was a scoop into which a drop of blood was collected, attached to a monitor that recorded the data. The scoop was discarded into a concealed and sealed container, in case of contamination.

Dan the Man was a spunky young fellow who deftly drove the Opera robot, attaching the bosons' chair with encouraging and flattering patter, putting patients at ease, He kept up a jolly repertoire, fancying his chances with the pretty nurse aides and because it was nearing Christmas he made it his job to decorate the ward. He made the most of his strategic placing of mistletoe in the Day Room, persuading a willing nurse to accompany him to help put it up.

It seemed to me to be totally surreal, being partially paralysed, unable to move without help, in a place so out of touch with the real world as to be on a completely different planet. It was something from outer space with aliens wired up to mother ship, or like me, caged in an electric adjustable bed that folded up into untold computations. It was supposed to make the patient comfortable, but with a squashy and plastic covered mattress and pillows that seemed designed to fall down on top of you, it was the most uncomfortable and horrendous form of torture imaginable. Inevitably I found I was squeezed up at the bottom of the bed entangled in heavy cotton blankets unable to attract attention or reach the gadget to summon help. The bed itself was operated by a control panel usually hooked on the railing at the side of the bed, so that the nurse could bring the patient up or down, and the bed raised up for easy changing of sheets.

"Would you mind if we emptied your urine bag?"

"Do you know where you are?"

"What is your date of birth?"

"Can you squeeze my hand?"

"Can I take your temperature?"

I had determined I would not wear a catheter for very long because from past experience it caused a bladder infection.

"The doctors have decided that you must have a tap on your catheter and you can urinate into a bottle" How ridiculous was that, to have a tube stuck up into your bladder with a wing nut attached and pee down it into a male bottle? Always providing of course that your frantic buzzing for a wee was answered in time. If the wing nut was not opened, goodness knows what harm that could do. I imagined myself blowing up into a squashy balloon, floating on a sea of, well that was too horrid to think of.

Needless to say it did not work because the tube was too narrow and the urine spilled out onto the pad thoughtfully placed beneath me. Thankfully I got my way and the wretched thing was removed.

By the time my daughter and some of the family arrived at visitors' time, I was in a good mood and seeing the funny side of my predicament. The whole thing seemed totally ludicrous, especially when the man opposite me said he was the Chairperson for a Stroke Club that had come down from the North of England for a Turkey and Tinsel treat in Weymouth. He had only just touched down at his hotel when he had a stroke himself. He could not get his head around it and kept telling everyone about his situation.

After a few days I was beginning to get used to the continuous monitoring, being rolled over to change sheets, having my private parts sprayed with a mousse and wiped by a male nurse, and being rescued from the bottom of my electric bed. There were several ways of doing this, either by a clever "slidey sheet" made of a slippery material that was pushed under the entire body and manually pulled up, or by grabbing hold of the patient who also pushed with the good leg until they were in a comfortable position. I rather enjoyed the sensation of brute strength this entailed. That and being whirled about in the fond embrace of Opera, preferably manned by Dan the Man. Daily visits by the team of specialists and retinues in attendance, the trolley of drugs dispensed by earnest and dedicated staff, and an occasional visit by a "po faced" individual without a shred of humour, was always accompanied by the swishing of curtains around my bed. This was probably

matched by the chaotic dispersal of trays of food to unwilling and often hopeless inmates. Food was ordered the night before and often forgotten choices resulted in petulant denials by the very old and disabled patients.

My daughter visited every day bringing cards of wellbeing from friends and neighbours and from people I did not know by name. I had no idea I was so popular. There were Christmas cards from abroad as well and letters that I could not read nor concentrate on. Flowers were not allowed in the ward. Something to do with health and safety regulations. So my daughter brought a colourful spray of imitation flowers, sprinkled with tinsel and bright with Christmas cheer.

Extraordinarily, my paralysed hand started to twitch in a reflex action when I yawned. I decided to name it Doctor Strangelove after the character created by Peter Sellers of a mad scientist whose arm had been damaged in an atomic experiment and had a tendency to want to give the Heil Hitler salute.

He must have studied the effects of brain damage. As a joke my daughter brought me a black glove, but unfortunately my hand scrunched up like a toddler every time we tried to put it on. I laughed so much that my stomach ached with the effort.

My foot too decided to give an occasional kick so I named it Johnny Wilkinson after a famous rugby player who had kicked a winning score in a World Cup. Apart from these spontaneous movements I remained with half my body like a lump of lead. My paralysed limbs had enhanced feeling, and it was a peculiar sensation not being able to move a muscle. My face felt as if I'd had an injection of Novocaine. Apparently the nervous system had been damaged and my brain had to find new pathways and set up an entirely new circuitry to electrically stimulate my muscles. It was expected to take at least two years. I could not wait that long.

FIVE

"We will keep an eye on it!"

The "Bridge" of Battleship Galactica as I liked to call the Stroke Unit was a central circular nurses' station where the personnel congregated to share stories of their exploits in the outside world and patient notes. It was not always easy to say which took preference. Patients were addressed by name, but at the station they were known by bed numbers. Patients were moved around so rapidly that this system became the only way that people could be recognised. Nursing staff were each given certain beds to look after, but more often than not they were distracted or called upon to help in other areas.

A more disorganised system could not be imagined. The problem was that there actually was no system and each carer was left to organise themselves. They thought of themselves as a team and thought they worked well together, without any real direction of time and motion. An incredible amount of time and energy was wasted in doing the most menial of tasks, with several trips taken where only one would have been sufficient. Very often two carers were required to work together on a task, and if one of them was engaged in helping someone else, then the priority was dependent it seemed on who shouted the loudest. This gave the impression of lack of staff or resources. Agency nurses were the most organised and efficient and I overheard one of them saying that our ward was the most chaotic she had ever encountered.

I came to the conclusion that to be a successful female nurse you needed a talent for selective hearing, be hyperactive and have a short attention span. "Be back in a minute" was a mantra said by all but never acted upon. A male nurse needed to be a plodder, be always on hand and be able to "go by the book" without question. Theirs was to do and die but never question why.

Another mantra often quoted was that they were short staffed. In fact they were very well staffed.

Lots of staff surrounded the station and miraculously disappeared to other areas at critical moments when patient buzzers sounded and were never seen again until the next rallying session. Hand over times at the end of shifts, took at least an hour of shared patient notes read out but never apparently digested judging by the number of times I was told that the person attending me had not been on the ward before and did not know my history.

Radiating out from the "Bridge" like the spokes in a wheel were various bays of four and six beds as well as cubicles that housed individual patients with private needs or in isolation because of infections.

There were corridors connecting to other parts of the hospital, with a series of security doors that had alarm systems in case mentally deficient or infectious patients escaped. I likened these to air locks in a space station.

One cubicle housed a male patient who had been on the ward for several months. He apparently had some sort of infection. It was spoken about in hushed tones. Amazingly he would be seen at night dashing around the corridors nude, urinating as he went, with a gaggle of screaming nurses running after him. He always had a good argument as to why he should not go back to bed, refuting the necessity for his incarceration. In spite of continued appeals to his better nature he managed to include himself in extra mural activities which made a nonsense of keeping him isolated from other patients. He was fitted with a security bracelet that set off the alarms at the security doors, but he still found a loophole and was able to get into the rest of the hospital. On one occasion he was forcibly made to return by a security guard, but ten minutes later he was out again chatting to the staff.

I asked why he was not locked in his room, but apparently it was against patient rights. Never mind the other patients' rights not to be infected. When he finally was discharged it was discovered that he had squirreled away several patient files and other sensitive material which he said was work that he was undertaking for them. I thought he would have made a hilarious character in a film with Gene Wilder playing the lead role.

It felt as if I had been in hospital for weeks, but it was only a few days. A couple of jokey orderlies arrived at my bedside to take me down to have a CAT Scan. My bed was deftly manoeuvred along the corridors and into the lift, and I was slid onto a board onto the motorised couch of the machine.

Computerised (Axial) Tomography is a type of deep tissue Xray machine that builds up cross sectional images of the body and displays it on a computer screen. My head was secured in a cushioning device and I was told to lie absolutely still. I was frightened to even breathe. Closing my eyes I could feel the couch moving backwards and forwards through a hole in the machine shaped like a doughnut, amid buzzing and whooshing noises. A series of Xrays were taken from different angles to give a very detailed picture of my brain to find out what kind of stroke I had, and its exact location.

The whole process took about half an hour.

The retinue of specialist doctors surrounded my bed.

"Your stroke was a clot in the right radial, at a very deep level. It will take a while to disperse."

"The cause was most likely from having an irregular heart beat that threw up the clot."

"We understand you also have cardiomyopathy, an enlarged heart!"

Wait a minute! How can this be? This must have occurred over a long period of time. Why wasn't it picked up before?

"If you get my heart under control, then the rest will follow" I responded weakly. They smiled sympathetically.

"My doctor told me there was absolutely nothing wrong with me and now you say that my heart threw up a clot into my brain and I have an enlarged heart! How can this have been allowed to happen?"

They shrugged.

"We will keep an eye on it" they said and went on to the next bed.

A duo of Occupational Therapists arrived.

"Come along now, its time to get you up!"

They manhandled me to the edge of my bed. I toppled to the left.

"Lean to the right!"

I tried but sloped to the left again. Eventually I got the hang of it.

"Now reach up with your right hand!"

It seemed a ridiculously difficult task and I started to laugh hysterically.

"Stop giggling and reach up!"

I could not understand why they could not see how ridiculous it was and laughed even more at their serious faces.

"Now we want you to wash yourself!"

They fetched a bowl of water and placed it on the table by the bed, provided me with soap and hospital face flannel and toothbrush. My daughter had not yet brought in changes of clothes or toiletries because it was thought I would only be in hospital briefly. I was left to manage as best I could using my good hand.

Now that I had mastered balancing so that I did not topple to the left, I was able to be pushed around in a wheelchair. I was instructed on how to stand by my bed and swivel into the chair. I could also sit on a commode without the hoist and without needing a bedpan. After several days in the Acute bay, I was moved to another bay with five other women. Apparently there were now more women patients than men. It was extraordinary how many people were having strokes, almost an epidemic. It surely was nothing to do with the Christmas season.

My sons in Australia and New Zealand had been terribly worried about me and had tried to contact the ward, but were told gruffly that they could get information from my daughter. However I was finally allowed to talk to one of them, and my daughter bought a voucher that enabled me to use the overhead television and communication console by the bed. At least that was the theory. The voucher covered a certain length of rental time whether the television or phone was used or not, and even then the money was not ever used up. The amount left always fell slightly short of what was required. It very soon became obvious that it was a costly scam. When we moved into new beds our phone numbers were automatically changed so that anyone phoning afterwards could not get through. Eventually I asked if I could use the computer in the Day Room to send emails to my sons.

The Occupational Therapists were delighted that I was able to work on a computer since not many

people my age were conversant with one, let alone be willing to learn.

However the downside was that once in the Day Room I seemed to be forgotten about and I was left on my own trying to attract attention from passers-by. There was no alarm bell to push to obtain help and anyone passing had selective hearing. The room itself seemed also to be a repository for unwanted bits of furniture and equipment. Odd easy chairs, crates of kitchen equipment and large orthopaedic chairs, wheelchairs and stacks of plates presumably from other rooms that were being redecorated were stuffed into the meagre space. Manoeuvring my own wheelchair was difficult in such a small space and I became adept at using my good foot to lever myself slowly and with great effort toward the door where I could shout for help. One of the OT's was adamant I should not do this as it would extend my back muscles too much. So how else was I going to attract attention and get back to my bed?

Quite soon I discovered I could use this method and with one good arm propel myself down the corridor. The look on the faces at the Bridge including some of the doctors walking the corridor was a wonder to behold. I even managed to get myself into a toilet and if the bell was not answered soon enough I propelled myself out again. Otherwise you could wait for ever sitting on the loo.

I was soon to discover that "keeping an eye on it" was another mantra, since everything we did or said was meticulously recorded in patient notes by each of our attendants. The number of times our notes were taken out to the Bridge to be copied and put into other notes for handover review was extraordinary and seemed to have little relationship to time and motion conservation. Needless to say my notes soon swelled!

SIX

Rag doll for Christmas "T'was the night before Christmas….."! I always love Christmas. It is not just because of the anticipation of presents, nor of the holiday spirit with food and drink. I love the whole process, the lead up to the great day and the slow progression of preparation. Generally too it includes all the myth and legend of thousands of years and the glamour associated with the mid-winter festival. I asked my daughter to bring in a special book that I always bring out at Christmas. Like Christmas itself, I never tire of it nor of reading the poems and Victorian stories and pictures it contains. The

scented pages of Penhaligon's Christmas invokes an immediate response to a bygone era when oranges were special treats and a simple hand made rag doll was a delight for a small child. It is the time of the Sugar Plum Fairy and Cider With Rosie and tales of Charles Dickens, and fantastic pantomimes. "…..and all thru' the house not a creature was stirring, not even a mouse ". Well that was not strictly true. For quite a while there was a forced sense of excitement brewing among the nursing staff. Dan the Man had finally got his way and put up fairy lights and decorations in the corridors and found the pieces of the large artificial Christmas tree and put it up in the Day Room. A radio was blaring out modern Christmas songs outside our bay, and like it or not the television monitors broadcast choirs singing carols from 6 a.m. courtesy of Patientline.co.uk. The lady in the bed opposite hated anything to do with Christmas, and complained bitterly about the enforced celebration. Her stroke had affected her right side and mine had affected my left side, so I suggested we link together with our good arms and use our good legs and dance Copelia for a Christmas treat for everyone. The thought put her in a good humour as we gained popularity with the staff when we invited them to our imaginary show.

"We have a special surprise for you!" The O.T. beamed. "You can have a shower!"

This was indeed a luxury not to be missed. I had been in hospital for eight days now during which time I had only had my white cotton socks changed twice. I had been amazed at how slim I had become and that my ankles were now the normal size. At last I could have my hair washed, couldn't I? The O.T. declared that it might be difficult but she might have time to do it later in the day. The last time my hair was washed was the week before I had the stroke, so it was stiff from perspiration and stringy from stress and pillow rub. The shower was an awesome experience in a wet room designed, it appeared, by a deep sea diver used to strong water pressures and not afraid of being thoroughly doused. I quite understood why the O.T's did not relish having to give patients a shower since they really needed to wear a wet suit.

My daughter and family arrived with bundles of mail from four corners of the planet, lots of bills to be paid, cheques to sign and magasines to read. Several patient families also became part of my daily visits and we joked and bantered about our condition and how surreal it was to be in this alien place at Christmas. It became a small world when it was discovered that another patient had been a bell ringer in our village church and her daughter came from New Zealand. Sadly she was very badly affected by her stroke and could not communicate. She had a wonderful smile but whether she understood what people said to her was difficult to know. In contrast another patient whose voice sounded like a character in East Enders never stopped talking in a whinging voice about the short comings of her rather ineffectual husband. Many of the women were very elderly and had husbands who really could not manage on their own let alone with a disabled wife.

I woke on Christmas Eve with a peculiar sensation of lightness in my left arm. It no longer felt leaden. I still could not move it except by the strange reflex action when my hand lifted up when I yawned. My left leg was still completely paralysed and standing on it was a very weird experience.

Although I could feel the ground on my foot I had no control whatever of movement.

"Sit on the side of the bed. Now step down with both feet and stand. That's great!"

"Now reach out with your right hand for the chair arm closest to you and swivel yourself around on your left foot until your back is in alignment with the chair seat! Yes, well done!"

"Reach back with your right hand to feel for the arm of the chair, lean forward and sit down slowly.

Don't plonk back into the chair… good, well done!"

It was surprising how exhausting this small exercise was. I felt nauseous and my head buzzed with the exertion.

"She transfers well!" The O.T. looked earnestly at the visiting doctor. "We will soon have you running around the ward!" he joked. Doctor P. was a very smart man in his early 40's. He exuded civil charm originating no doubt from his German background. His bedside manner was impeccable, with just the right amount of warm reserve. He even clicked his heels and gave a little bow upon retiring from the consultation. He squatted on the floor beside me and spoke confidentially discussing the probable causes and possible future treatment of my condition.

"The Cardiologist thinks that you should have an angiogram. How does that sound to you? They go in through the groin. It is virtually painless. However since the Christmas season is intervening, it wont be until the New Year now." I suppose that's okay. What is an angiogram anyway?

"Meanwhile we will continue with the stroke medication and negotiate with the Cardiology people when the most convenient time is for your next treatment with them. We don’t want to lose you to them." He peered into my eyes.

"How are you feeling? You look a lot better!"

"Oh I guess I'm okay under the circumstances. I am a rag doll!" I explained how I and the lady opposite were going to dance Copelia for Christmas. Doctor P. looked amused, raised himself effortlessly to a standing position and with a little click and a bow took my hand and said goodbye.

Judging by the suppressed giggles and merriment at the nurses' station, there were attempts at preChristmas partying. Dan the Man was in his element, jockeying for position with his favourite willing nurse aides. We were handed the menus for Christmas and Boxing Day and because I still had difficulty chewing without masticating my cheek as well, I chose a soft dish. Fricassee of Turkey sounded tempting followed by Christmas pudding and a mince pie. We could opt for a piece of Christmas cake for afternoon tea and for supper perhaps a ham salad and trifle. My daughter promised the whole family would visit with presents and some of their Christmas hamper after dinner, some time in the late afternoon. It all seemed incredibly unreal and incongruous.

Christmas Day dawned with the staff nurse wearing a jolly Father Christmas hat and the nurses dressed in a variety of tinsel and flashing lights. We had been persuaded to have our normal clothing brought in and I wore my bright Christmas jumper to get in the mood.

"Would you like to have your lunch in the Day Room?" It sounded a lovely idea, to get out of the ward environment for a change. The lady across the way, with whom I now had a shared humourous outlook on our whole condition, said she would join me. We were wheeled along the brightly decorated corridor to the room where a large artificial tree stood. The lights were twinkling merrily and music played from a digital radio, giving a festive feel. Three men in various stages of stroke disability sat mournfully at a table that was piled high with Christmas crackers. There was a festive cloth on the table with napkins to match. We were squashed in between the men in their massive wheelchairs, oxygen bottles and huge feet. No one spoke, no one could pull the crackers and my meal looked distinctly unattractive with pieces of turkey swimming in orange gravy. A tiny bullet of stuffing poked out of the mess, as if some unfortunate creature had left its deposit in the wrong receptacle. Thankfully someone came in to say my son from Australia was on the phone and I was wheeled out to the "Bridge" to take the call.

I returned to discover a bowl of custard in which an overcooked individual Christmas pudding was submerged. The men had drunk their beer and wine and were now feeling talkative. I mentioned

that my sons were in the Antipodes and one man started to tell me what New Zealand was like, even though he had only visited that country on a three week trip. I said that I had lived there for 35 years and living there was a bit different from being on holiday. He seemed the aggressive type who was not used to a woman disagreeing with him. The men were wheeled out, leaving me and my friend sitting at the table. Once again there was no way of letting anyone know that we were there.

After a couple of hours, someone poked their head around the door.

"Oh, are you still here?" Of course we are. How are we supposed to do anything different?

"You should have buzzed!" Actually I thought of screaming.

My daughter and family arrived laden with parcels and cards and titbits. In a bemused state I tried to open packages with my good hand, aided by my grandson. Such a wonderful collection of gifts and a specially beautiful bright red fluffy dressing gown, soft and luxurious. Just what I wanted. We talked of Christmas past and Christmas present and wondered where we would be next time. Suddenly I felt everything was going to be all right, surrounded by my loving and caring family.

"A Happy Christmas to all and God bless us every one".

`

18

SEVEN

"trust me I'm a doctor - this won't hurt a bit!"

The party mood continued through to New Year's Eve. It all started to resemble a Carry On film with suppressed giggles, flirting and raucous laughter coming from the corridors and spilling into the bays. Several of the nursing staff admitted to hangovers and one or two of the care assistants became adept at avoiding work by hiding behind curtained beds, or dashing about as if on some urgent errand.

Actually I was amazed at how anyone coped with the crowded and narrow spaces between the beds. The architect had obviously not allowed for the size of the ward furniture and certainly not for orthopaedic wheelchairs and easy chairs, stools, bedside cabinets, commodes and trolley tables laden with personal effects. There was hardly any room left for urine bag stands, monitoring stands or nursing staff, and the curtains when drawn barely covered the people trying to keep a certain sense of dignity. Put the various robots into the mix and you have congestion on a large scale. At one end of the six bed bay there was a space supposedly for storage and a wash hand basin. My bed was squashed up against it.

Several patients had been transferred to other hospitals or care homes with beds filled with new patients, and a new woman in the bed opposite me suddenly sat straight up like something from Friday the 13th. She must have had amazingly strong stomach muscles, but poor thing, she looked as if she had been badly beaten up. When her daughters arrived she tried to speak to them but it was just garbled nonsense. Apparently she had fallen down stairs, but it looked far more serious than that. The next day when the care nurse came to wash her she did not move but was making horrid guttural wheezing noises, similar to those I had made when I was dying.

A flurry of doctors came and assessed her and her daughters came to sit with her. They did not speak to her but just held her hand. The sound of her struggling to breathe made me feel terribly anxious and I asked one of the doctors if she could be put somewhere more private.

The curtains were not even drawn around her and noisy visitors were spilling into her space. A nurse came with a syringe to make her more comfortable and left. The woman was less restive but continued to labour for breath. She continued like this for several days and eventually died in the middle of the night without her family around her. The bay doors were shut so that no one could see her being transported in a body bag. A bit stupid really since we had all been witness to her dying. In fact several patients died in the ward. After all they were mostly very old people and everyone has to die of something, some time, somewhere.

"You have been booked for an angiogram tomorrow" "It won't hurt a bit. You have a local anaesthetic, which probably is more painful, then the surgeon puts in a guide wire into your artery and a catheter with a tiny camera on it to see if there is a blockage and examine the heart vessels. They usually go in through the groin".

"Yes and then they inject an iodine solution so that they can see what's happening. It all

shows up on a television screen and you can see it all happening".

Sounds like fun. Well at least it is all educational I suppose.

Can I scream now?

Well at least I won't have to listen to the poor person opposite in her last throes any more.

The staff were still negotiating with the cardiology department to allow me to return to the stroke unit after the angiogram. This dichotomy was to continue throughout my treatment including a discussion about appropriate drugs to prevent another stroke and the efficacy of drugs to control my heart problem. One lot were not required for my heart but were necessary to prevent another stroke. I always maintained that once my heart was under control, the rest would follow. Doctor P. agreed and we had quite animated discussions about it and the possible causes. I still wondered if something more could have been done to prevent it all happening in the first place.

I was beginning to have some movement in my fingers, though precious little in my limbs. As the movement began, of course, pains from unused muscles also began. Muscle spasms caused by reflex action were very powerful and every time I moved my right hand, my left hand stiffened, or crunched up. My fingers felt as if they were burning up and held in a vice. I massaged them as much as possible trying to release the tension. One of the occupational therapists came along with some massage oil and declared that I had the nicest hands she had seen for a long while. "The knuckles are so flexible" she declared. This only happened once the whole time I was in hospital. Perhaps it was only needed one time anyway.

Two orderlies took me and my bed and personal effects and all my notes down to the critical surgery department where I was to spend the night in preparation for the angiogram the following day. I occupied a space by the door. From my vantage point it seemed to be a very long ward filled with groaning and coughing women. Some of them seemed to be suffering from a stomach complaint judging by the gurgles and sounds of straining behind closed curtains. As night fell and the lights were dimmed the woman opposite me set up a loud wailing.

"No, no, no! Oh no, nooo, oh no! Please, please not again. Oooh, not again". This went on and on, more and more urgently, followed by anguished loud crying. Someone in the ward buzzed for a nurse, who came and asked the woman if she was in pain. They fetched a commode and tried to get her to use it.

"Push, push! That's right push! I know it hurts but if you don’t push you will be in more pain" Nothing happened. She was given a suppository and settled back in bed. Once more the ritual began again. "No, no, oh no, not again". More wailing louder and louder. Anguished crying louder still. A night duty nurse bustled in and said to her that she was disturbing everyone and to be quiet. "Why do you do this at night? You don’t carry on like it during the day!" The woman stayed quiet. However the next day she decided to start again. When I asked her why she kept saying "No", she said she didn't know! I suggested she tried saying "Yes" instead!

In contrast with the stroke unit, this ward was run like a military exercise, with everything in strict routine and at the correct time. All was smooth and well oiled, everyone working in unison, sharing tasks and knowing exactly what to do. I was given a nice shower with the nurse helping me to wash. My legs were creamed and new stockings peeled on. They were amazed that I had not had a change of stockings for several days and that I had only had one

shower since coming in. I felt cared for. I was helped into bed and tucked in and a doctor came and assessed me ready for the coming surgery.

"Of course there is always an element of risk in this procedure", he beamed. "Sometimes the catheter may go through the wall of the artery. If it does of course there is general panic and you may bleed a lot!" He paused for greater effect.

"But this is not likely to happen. There have been only a very few cases where things have gone wrong. And of course it may cause another stroke or even a heart attack. We will need your consent to go ahead with the procedure!" He passed a form to me that I signed.

"Do you know Mr. H. ?" I did not. "Well he knows all about you and is looking forward to meeting you". I felt flattered. "I will most likely be there as well and we can watch the pictures together!"

I was wheeled into the radiology room full of very high tech equipment, wearing a hospital gown and little else. Cotton blankets were draped over me as I lay down on the narrow surgical bed under an array of screens, lights and other humming equipment. My right arm was strapped to a bracket so that it remained rigid, and Mr. H. introduced himself.

"Trust me, I am your doctor and this won't hurt a bit. Instead of going in through the groin, I prefer to go through the wrist. It is more direct and we want to see if your arteries are clogged or not, and whether you have heart disease. I am going to insert the catheter and then you might feel a little bit of heat as we inject the iodine solution. We will take pictures as we go along and you can see them on the screen."

As he talked he gave me a jab of local anaesthetic, followed by a very powerful jab into the artery in my wrist. The anaesthetic had hardly had any time to work. I yelled and my left arm started to spasm. The female standing beside me held my weak hand encouragingly. The catheter was slowly manipulated up into my forearm and then got stuck. For some reason the muscles had contracted preventing movement either forward or back. For maybe several minutes that seemed like hours Mr. H endeavoured to loosen the catheter, massaging the area, but without effect. Suddenly something very hot and burning was poured into my outstretched hand. I screamed "Its burning! God it hurts, its burning". Talking to the female over the top of me he explained that this sometimes worked.

The reaction released the catheter and in a few seconds it had been pushed up to the desired position. I could see the iodine flooding into my artery and veins on the monitor above me and then I closed my eyes and let it all happen. There was the noise of fans and machines and digital sounds of computers. I let it wash over me. Then after about an hour Mr. H said, "Someone shout", so I did, and the catheter was pulled out. He looked down at me and told me that my arteries were perfectly clear and there were no obstructions anywhere. I did not have heart disease. He seemed overwhelmingly pleased and relieved. I don't know why because it was something I had never entertained. He kept repeating what he had said and almost to himself, "That's good. Everything is clear!" He shook my hand and handed me over to the expressionless and earnest young woman who had held my hand.

"There is a special pressure pad on your wrist attached to the catheter needle. You have to lie quietly for several hours and the pressure will be slowly released every ten minutes, then every half hour and then every hour. This is to prevent a haemorrhage". She gave me written instructions to give to the staff nurse. "It must be closely monitored to prevent infection. Any sign of swelling or discolouration must be reported immediately".

I was wheeled back to the ward and the nurses were fascinated to learn what the whole procedure had been like. They thought I had been very brave. I sank thankfully back into my adjustable electric bed with a hot drink and fell asleep.

I spent the next few days being very well looked after and then the stroke unit people persuaded the cardiac people to release me back to their ward. I felt like some sort of celebrity with everyone anxious that I remained in their orbit. "You have such a positive attitude that rubs off on others. We don't want to lose you"! I was welcomed back with open arms and to total chaos.

EIGHT

"it’s the brain that is damaged, not the muscles"

Whilst I had been in the surgical ward, it was all change again in the stroke unit. Several women had been moved out and others moved in and I found myself next to a very pretty and pampered looking woman with a halo of fluffy white hair nestled on a bed of puffy pillows like a diva. Her delicate hands fluttered like baby sparrows as she gave the nurse orders that her covers needed rearranging. She was adamant that her eye drops should be given in the correct order and that her medications should be given in water whether they dissolved or not.

"I always take it like that!" She refused to allow anyone to touch her and whenever a hard pressed nurse tried to insist she took her medication she would wave her hand and say "I am not ready!" It was policy that no one could force her to take her pills or be made to have treatment.

At mealtimes, she sat with her bowl of food in her hand and went to sleep. How she held on to it I do not know. She refused to be fed by anyone and forcibly waved them away if they tried. "I am not ready!" she shouted when an aide tried to undress her for a wash. She wore umpteen layers of dressing gowns to which she clung, declaring that she was too cold without them. She became incontinent but still refused to change her clothing. Her family visited and declared that she would be better off at home and that she was not being looked after. She came in looking sweet and pretty, and went out a grumpy old crone. Incredibly as she was being wheeled out she clung to her hospital bed and said "Stop! I am not ready!"

New Years Day dawned. It had been a busy night at the nurses station with partying and noises of fireworks being let off somewhere in the town. The hospital chaplain appeared by my bed and asked if I would like to come to the chapel service that morning. A rather dispirited looking man, he gave the appearance of fighting a losing battle. He said he would personally wheel me down to the chapel and that others would be coming with their carers. The chapel was a specially designed circular room with etched windows and modern works of art on the walls, that gave a feeling of tranquillity amidst the traumas around it. There were possibly about twelve people there in various stages of recovery stoically refusing to meet each other's eyes and smile in case they were going to be asked questions.

We attempted to sing the conservative style hymns somewhat off key, and the regulation Church of England readings from a pamphlet with responses were repeated parrot fashion.

Curiously, the sermon was particularly immemorable and had no bearing at all on the fact that this was the first day of the new year. I felt that a wonderful evangelistic opportunity had been missed with the Christian declaration that the old life had been forgiven, giving all who believed

freedom in the present and hope for the future. A wonderful healing message, especially in the hospital setting and in fact in the global setting as well. I strongly felt that the message was in the wondrous healing power of God, and if I had been healed, then everyone else could be.

Taking it even further, given the choice to heal or take, God would always heal. Instead of making the choice oneself, it was essential to give it back to the instigator of life. In the final analysis the choice is not ours, and as a Franciscan brother once told me, "death is the greatest healing of all". A paradoxical consolation.

My friend's relative had given her a book by David Hind After A Stroke that she lent to me to read. She had not felt very well after her stroke and could not make sense of what she was reading, so would I give her an idea of what it was about.

The author had had several strokes, including one where he had lost his voice, so he decided to write his thoughts instead. The passage I found most encouraging was the revelation that although the brain was damaged, it would with encouragement find another pathway to help the limbs to respond to its electrical messages. The muscles were not damaged, but they needed to be stimulated by the brain to work. The critical moment for this to happen was in the first weeks after the stroke. If left too long, the muscles could wither. However if made to work too soon and incorrectly, it could do more damage than good to ligaments and even cause bones to dislocate.

This explained the rather reticent behaviour of the O.T's in not wanting to manipulate my arm beyond lying it carefully on a pillow for support and insisting that I sit with both feet squarely on the floor. I had to lie on my back with both sides of my body in harmony with the other and avoid lifting my knees up. It was incredibly uncomfortable after a while and my right buttock felt squashed and numb not being able to change position easily. My friend became quite agitated about it and was often in tears when no one answered her call to be made more comfortable. She ended up with a trapped nerve in her groin and squealed loudly whenever she was moved.

Over the next week a stream of people from my church, including the assistant pastor came to visit, and of course friends and relatives dropped in as well. My daughter and grandchildren came every day with messages and cards from others, and the wonderful and caring attention was an enormous help in my recovery. I was now able to move some fingers and my big toes, and there was some movement in my limbs but no co-ordination. With it came painful contractions, and muscle pain in my back. Of course I had had back pain before I had the stroke and I usually treated it with a drug that eased inflammation. However this was not recommended with all the other medications I was taking so I had to grin and bear it.

"Can you touch your thumb with your little finger?" You are joking of course. I can't even touch my first finger with my thumb, or for that matter move my thumb anyway!"

Doctor P smiled up at me, squatting by my chair in a conversational way.

"We are thinking of putting you on Warfarin to thin your blood so that your heart does not have to work so hard."

I had always hated this drug that originally was rat poison and seemed to make old people's skin blotchy and prone to broken blood vessels. I dreaded having great red patches on my hands and face.

"Do I have to?"

"Oh, yes it would be best, and we will monitor it which means you have to have regular blood

tests until we get the dosage right. It wont necessarily cause you to have blotchy patches.

That only happens with very old people!"

"We think you are ready now to go into Rehab. You have made remarkable progress and you will be able to have physio several times a week. Soon get you up and walking!"

I could not wait.

Several of us, including my friend were moved into a newly painted bay. My bed was put by the window and I no longer had the safety of bed railings to hold onto to drag myself up. I had now to train myself to be self reliant again. After all I had to be, since no one else was there at home to look after me. I would learn to use one arm to wash and dress myself and to balance without leaning to the left. This was going to be a challenge but also cause much hilarity as I got myself into impossible situations, much to the consternation of the staff.

According to the book about the effects of a stroke the patient either excessively dissolves into tears or laughs inappropriately. I suspect the staff thought it was the latter!

NINE

"memories of life's traumas are stored within your body" My friend was in the bed next to mine and I kept an eye on her as she seemed to worsen instead of improve. She seemed to easily get into a depressive state in spite of a very attentive family who gathered around her and massaged her affected arm and leg. Her hand was almost useless and misshapen and she was given a brace that was specially moulded to her hand. She was supposed to wear it during the day and have it removed at night. This meant constantly reminding the carers who were often new on the ward. One night she was found to have a temperature and when she developed a terrible honking cough, was put on oxygen and antibiotics to relieve the infection. The robot Encore was utilised to help her to stand and be transferred from bed to chair and back which inevitably turned into a comedy in itself.

The woman opposite me was a vicar's wife, very middle class and terribly apologetic. She also had a cough and appeared to never have been ill in her life before. In spite of her very prim demeanour she had the most remarkable bladder capacity that seemed to go on forever.

Behind discreet closed curtains, it sounded like a horse. I thought I suffered badly from flatulence that greatly amused my grand children, but in comparison, this woman put me to shame. I had never heard such long sustained farting from a man, let alone a prim church woman. In spite of her imagining that she was having a heart attack, the doctors could not find anything untoward, and she was sent home.

Next to her was a woman who just would not settle. She kept getting out of bed and paced about saying she wanted to go home. She became more and more agitated as the nurses tried to explain that she was not ready to return until the O.T's had assessed her environment. She insisted that her home was a lot better equipped for disability than the hospital and she could easily manage on her own. Wanting to keep strictly to procedure they would not discharge her.

Used to difficult and often dementia patients they would not give in. Her family and friends visited and she tried emotional blackmail to get them to have her released, crying and making such a fuss that they did not stay long. When finally the social workers went to assess her home, they discovered that she had a beautiful wet room and grab rails all over the place. It had been fitted out with all the latest apparatus. Apparently the previous owner had been disabled and she had never removed the equipment. She was happily discharged.

At the far end near the door was the lady who used to be a bell ringer. She seemed to be much the same with her mouth open in a grimace and a sore tongue hanging out. She was completely paralysed and could not speak, but she had wonderful smiling eyes. She was fed through a tube in her nose and had regular mouth swabs. The nurses loved her and fussed about around her, constantly shifting her position and changing her sheets. Opposite her was a person we all thought was a man. She had a very deep voice and in spite of being shown how to use the gadget that summoned a carer, insisted on calling "nurse, nurse" in a voice that sounded like a baaing sheep. Needless to say they ignored her bleating. She too had the same honking cough as my friend and was given the same treatment.

People came and went with such rapidity that it seemed almost like a conveyor belt, each one with different sorts of responses to brain damage from a stroke. The peculiar thing was that no sooner had they gone than we forgot their names and very soon hardly remembered them at all. I wrote poetry and sketched on whatever paper was handy; the back of envelopes or on paper napkins. I wanted to remember them somehow. There was nothing else to do except stare at a television or listen to the radio. With little to stimulate the imagination, it soon turned into mind numbing boredom. Although I had been given magasines and books to read, with only one workable hand, it was almost impossible to hold them. I had my daily workout being wheeled to the bathroom to wash and dress using one arm. And that was a curious thing because most patients were in wheel chairs yet the vanity mirrors and paper towels were placed well above reach. The toilet paper holder too was often just out of reach. It required a cunning plan to work out the best way to overcome these obstacles!

I got used to being attended to by Igor or Dan the Man, being lifted off the toilet, having my bottom wiped and settled into bed. When I had terrible diarrhoea, Igor came to my rescue and calmed my disgust at the terrible mess and smell in my newly laundered pyjamas. He removed the clothing carefully, swabbed me down and sent the offending items to the hospital laundry.

Dan the Man lifted me gently under the arms and manouveured me carefully to sit on the toilet, retiring discreetly until I finished and then putting me gently back in my wheel chair. I got used to being stripped by an O.T. and being pummelled by the power shower and left to bask for what seemed like hours under the jet. It was impossible to move. I knew why we were called patients, since we needed patience to put up with it.

"How would you like to have a meditation session in the Day Room?" the O.T. bustled by my bed asking everyone who might be interested to come along at eleven that morning.

"The whole session will take about an hour and you will be back in the bay by lunch time. I am sure it would be very beneficial and some of the staff are going as well!"

I was a great fan of meditation and actually found the practice extremely helpful in times of stress. Ridding the mind of all thought gave it a good holiday and one was able to recharge immediately afterwards. It helped too with the creative process.

Yes I would like that very much! Anything is better than this mind numbing inactivity!

About five people sat around in wheelchairs and easy chairs while the Bowen Technique Practitioner explained what it was all about and what the procedure would be.

"Bowen Technique was created by Bowen in Australia in the 1950's. It is a technique using a hands on, non-invasive healing method that affects the autonomic nervous system, releasing tension and stress. Although his career as an industrial engineer was not related to alternative medicines he became interested in massage techniques including Reiki. Soon he had built up a substantial following of clients but found he could not attend to them all in a continuous series

of sessions. He experimented with group therapy and discovered that by spacing the sessions and by giving breaks during each session, the therapy gave more effective results. It seeks to release stored up memories of past traumas within the body, bringing about the resulting harmonic frequency of body systems".

I remembered taking part in various techniques for relaxation in New Zealand in the 1970's and heard of the Bowen Technique but had never taken part. There the sessions were far too expensive for me and yet here I was care of the N.H.S. about to undergo this alternative healing method free of charge. Apparently it was widely used since the 1980's in Europe and in Britain in hospitals and private clinics, with special training colleges for the practice in different parts of the world.

Putting on some flowing relaxation music and an aroma therapy lamp, the Practitioner told us that we might experience an outpouring of emotion or even a deep spiritual feeling after the first session as our bodies released tension. She would come to us each in turn and touch a specific point on our head, neck and shoulders, lasting only a few seconds. Each person's therapy would be different, according to their needs. She had been fully trained to be attuned to our specific harmonic requirements.

I could feel that there were one or two people there who were probably more than just a little sceptical, especially when a spiritual experience was mentioned. I noticed my friend who had agreed to accompany me, stiffen perceptibly. This was compounded by the realisation that the man who was supposed to be in isolation due to an infection was sitting next to her. Although there was a very strict rule about using an anti viral hand gel, the fact he was in the room at all and was being touched may spread his infection to others.

"Sit comfortably, head up, shoulders relaxed, hands on knees, feet squarely on the floor. Close your eyes and take in a deep breath, one, two, three, four, five. Release your breath. Nice and slowly, breath in again, relax and breath out, letting all tension go with your breath."

I have done this before so many times!

"Now I want you to imagine a special tranquil place. A place where you have felt peaceful and happy. It might be a real place, somewhere you have lived or been on holiday, or it could be an imaginary place".

I visualised my hillside garden in New Zealand where the cicadas used to chirrup and I lay on the sun deck looking up through the pine trees to the blue sky beyond.

"This is your safe place, a place where no one can hurt you. It is your sanctuary!"

Strangely in reality I never felt particularly serene there. Some of my most traumatic times were in that place.

We sat listening to the music waft over us as she came to each one in turn. She pressed against the back of my neck, rolling her thumb over one side of a pressure point and then the other. It seemed to take ages for her to get around to me again, and she gently caressed a different part of my neck and head. I gradually went further into a meditative state, being brought back again by each therapeutic caress, but when she started to massage the deep worry lines between my eyebrows, I suddenly started to weep. Overwhelming feelings of sadness swept over me, and I felt lost and vulnerable.

I was incredibly embarrassed crying so deeply in front of so many people who also obviously were very disturbed by my outburst. Someone made a silly remark about letting go, and not holding on to my past life. This was my time now she said. I felt angry at the triteness. I had

always had to be so strong for my family. I knew I could not do it any more. "The problem is," I shouted through my tears, "not only do I have to let go of being strong for my family, I do not have the physical resources left to be strong for myself!" The realisation of extreme weakness was more than I could bear. I had always had to be strong for others, but now who was going to be strong for me?

People always said that they thought of me as being very independent, whereas in fact I had had to be self reliant because there never was anyone who offered their help. If I did not do what needed doing, then who else would? Even if I did ask someone, the job would be done months later. I wanted things done now! I was going to have to become reconciled to the fact that nothing was that important. A completely different lifestyle was going to have to replace the old one. If I employed people I had to accept their way of doing things. The thought was daunting and I retreated into my numbness.

TEN

"why are we waiting?"

I was excited to find that I could move my arm, turn my hand over and lift it above my head.

There was a dreamy young French nurse on the ward, and he wanted me to show him what I could do. Having carefully tucked me into bed for the night, I went through the paces, stretching my arms up high and clapping my hands. I did not let on that it was extremely painful, or that my fingers remained stubbornly stiff and unusable.

"Zo clevair madame!" he crooned. I felt I would do anything for him.

It was a break through and I was inspired to try to get out of bed on my own as well. A wheelchair had been allotted to me for my personal use, and in spite of its inconvenience, was parked in a space between the window and my bed. A very old and frail woman now occupied the bed opposite and she seemed to be inspired by my efforts. Generally she lay against her pillows with her hands like baby birds poking out of the nest of sheets, waiting for someone to feed her. Now she began massaging her hands trying to move them. However with the added activity she seemed to need to go on a commode every half hour or so. This meant that Opera robot had to be used to hoist her out of bed and onto the commode and back again.

There was hardly enough room for my wheelchair and Opera and when the staff brought in an orthopaedic easy chair as well for the frail person to use, my wheelchair was relegated to the wheelchair parking bay right down the end of the corridor. This was incredibly frustrating because the staff felt I should be able to look after my own needs, and resented having to

bring me a commode or a bed pan. This created a battle of wills between me and the rather uppity staff nurse.

"That wheelchair is mine. It has my name on it. If you take it away, then I will be forced to keep asking for someone to fetch it each time I want to go to the toilet or to the Day Room!"

"The wheelchair is not yours. It belongs to the N.H.S." "The wheelchair has my name on it and it was given to me for my personal use!"

"We can always take your name off it and it belongs down with the other chairs in the corridor."

"Alright then, I will need the chair now to go to the toilet and after that I will want to go to the breakfast club in the Day Room. After that I will need to e-mail my family in New Zealand, and then there will be another trip to the toilet, by which time it will be lunch time. Are you prepared to tie up your staff by having to fetch a wheelchair for each trip?"

Briefly she capitulated and it was the main subject for discussion at the Bridge. This particular staff nurse seemed to think she was the bee's knees. She came waltzing in one day with her arms outstretched "Da Da" she said "can you see anything different?" We could see she looked neater. "I've had my hair cut!". She twirled so that she could be admired and rushed out again to the men's bay where she stayed a bit longer! She seemed to do a lot of posing for effect that was completely lost on most of us, because all we were interested in was the next meal or our medication.

Neither of these were ever on time. It seemed that the trays and plates of food that had been chosen from the menu the night before were put into a warming trolley, similar to those used in airplanes. There they waited in the corridor until the food was the right temperature, or until someone felt disposed to serve it. Watching how this was done it appeared to be a major task.

Plates were taken out and put back, menus referred to, sorting and rearranging went on. And finally someone came in with a tray and tried to find space on the laden bed trolleys. Some frail people required to be fed, either because they could not feed themselves or because they would not.

I became adept at using a fork American style. I would cut up my food with my right hand, and shovel it in my mouth with a fork using my right hand. It was not too difficult. I used the end of a fork to pierce the airline style fruit and yoghurt cartons, and used a similar method to punch a hole in fruit juice cartons. With a little ingenuity I was able to cut up fresh fruit and open individual butter pats and marmalade sachets. It just took a bit longer than previously.

However I did need help buttering my toast in the morning. Using only one hand, the toast skated across the plate and onto the table top, with butter and marmalade smeared on everything in between.

On one occasion we waited for several hours for our evening meal. Many of us had to take our medication with our meals, ostensibly at exactly the same time every day. With the irregularity of the service, this was wishful thinking. The staff nurse on duty was a large and dedicated person who had been on the ward for years. She was imposing but was said to have a good sense of humour. Getting fed up with waiting, I and my friend in the bed next to me started to bang our forks on our trolley tops. We set up a chant "Why are we waiting, why are we waiting, why are we waiting, why are we waiting?"

The door to the bay flew open and staff nurse came in looking daggers at us "You wont get any supper for that" she shouted, and burst into laughter. It became a hot topic for conversation at hand over and for many days to come I could hear her telling others "and they

sang it so loud!"

The medication trolley was locked when left unattended. There were only two or three people who were sanctioned to serve medication and they had to make sure every patient took their doses. Sometimes they had a student with them, and one particularly precise little man had a very loquacious person with him who hung on his every word. You could hear them coming a mile away. They discussed the patients over the top of them and what the medications were for. They seemed locked in their own peculiar world discussing past experiences and triumphs.

After a while their sycophantic involvement with each other palled, as they doled out pottles of pills and liquids, with only a glance towards the patients to make sure they took whatever had been allocated. I never did get to the bottom of their relationship. He was clearly flattered by her attention, but think it might have been wasted since he seemed to be a loner and the hospital was his love.

The man who did the blood tests was a Polish immigrant who had been in Britain for three years. Rather surprisingly he had a German name the same as my grandfather. If he had said he came from Transylvania I would not have been surprised. He walked around the wards with a trolley filled with vials of blood to be deposited in the Pathology department laboratory. He must have got used to the jokes about Dracula, yet he seemed to take as much delight as the dreaded man must have done in taking patients' blood.

I had had a mastectomy some years ago and my right arm did not have the protection of a lymph gland. Although I had kept telling various people that my right arm was not supposed to be stuck with needles, no notice had been taken. The excuse was that my left arm was too weak to be utilised. When I mentioned it to this man he stood to attention and placed a green band on my right wrist stating it was not to be used for blood tests. Eventually however, this too was abandoned because it was virtually impossible to draw blood from my left arm anyway.

The veins were too fragile.

Several of the care assistants were young unmarried mothers. One in particular seemed to find her baby rather difficult to handle at night and appeared to suffer from sleep deprivation. In the ward she was a scatty mess, bouncing around like a rubber ball, highly hyperactive and with low attention span. She seemed to know the words to all the most recent tunes and jigged about distractedly to the rhythm. She was accident prone and clumsy and adept at making the job seem longer than it needed to be. I suggested that she needed a plan of action so that she could achieve the most with as little wasted energy as possible. All it needed was forward planning. She seemed to think such a thing beyond her ability. Besides it all gave the appearance of intense activity without achieving very much, all in the name of lack of staff.

One person I greatly admired was a care assistant with grown family. She had married in her teens and was obviously very fond of the poor frail people in her care. She would spend hours carefully feeding and fussing over those who were unable to feed themselves and once or twice helped me to the bathroom. She always had a ready smile and giggled a lot whenever she attended to me. On one occasion the bathroom was very smelly after a male patient had been there and she grabbed a can of what she thought was air freshener. She gave it a swirl in the air above my head, and I was covered in the mousse that was used to wipe bottoms. We collapsed in shrieks of laughter.

Whenever this person helped me get into bed I invariably lost my balance. Her giggles were so

infectious that I could not control my feet and got them tangled up with laughing so much. As if in a slow motion movie I fell slowly backwards with my good arm waving above me, like some drama queen, flopping on the bed and unable to get up. The funniest thing was the look on everyone else's face, which only made us laugh even more. Once I got started I could not stop and my sides ached with laughing so much.

ELEVEN

"to infinity and beyond"

I had been in the ward for twenty eight days, though it seemed much longer. My daughter asked if it was possible to take me outside in the wheelchair. I was wrapped in my woolly dressing gown, with a scarf and woolly hat. My right hand was gloved but the left hand kept closing up each time she tried to fit a glove on it, and I sank into uncontrolled laughter with the extraordinary difficulty of trying to get my fingers into the glove. It was like regressing to toddler age. Finally I was wrapped in several layers of blanket and was ready to face the wintry elements. My grandson took control of pushing me along the corridors, through the security doors and out into the fresh air of the hospital grounds.

"Open your mouth and say aahh" he said.

"Aaaaaa aaaah! Aaaa!"

As the chair was pushed over uneven surfaces my voice rattled, which made us laugh. He enjoyed running at speed down the slopes and in and out of pillars and around obstructions so that I squealed with excitement. My daughter declared that it reminded her of when the children were in their push chairs.

The trees in the gardens still clung to their autumn leaves and daffodils were coming into bud.

Spring would be early this year. I felt as if I had been sent out of the space ship on a mission to infinity and beyond. I was taken to the perimeter of the hospital grounds so that I could see down the main road to the town. It was like gazing at another galaxy. It was so different from the peculiar environment of the stroke unit that it seemed like a completely alien planet. It was literally "the outside world".

I was taken on a tour of the hospital to admire the art work being displayed in the public areas and corridors. We noticed where the café was for the next outing and I was taken back to my Rehab bay just in time for tea.

"Lie down on your back and lift up your knees". The physiotherapist regarded me with a severe gaze.

"Now move your left knee slowly to the side and back to the centre. Keep it steady!"

I was amazed at how my leg trembled and refused to go where I wanted.

"Do the exercise five times slowly".

I puffed and blew with concentration to stop my left leg from wobbling about.

"Well done. Now keeping your knees up, slowly lean the right knee to the right and back to the centre. Keep the left knee steady!"

This is ridiculous. It's even more difficult than the other one.

"Good, now spread both knees apart. Slowly now, one two three four, five". I feel exhausted!

"Well done!"

"Now lift up your back making a bridge, squeeze the muscles here and repeat the whole exercise, lowering your back and relaxing between each one."

Love the pain!

"Put your knees down and lie flat. Now lift up your left buttock". This feels very unnatural.

I can't feel my left buttock!"

"Turn on your side and bend your left knee. Now lift your knee up and hold it there. This is to strengthen your large leg muscle". I cannot feel it let alone lift it up. What muscle?

"Good, well done".

"I am learning about muscles I didn't know I had". The physio regarded me with disbelief.

"You can do these exercises on your bed". Okay! It will give me something to do in the early hours when the night staff come to see if you are still alive!

An O.T. informed us that the Bowen sessions were in the Day Room and get ready for eleven o'clock. My friend decided it was not her thing and had felt it all rather overwhelming. On this occasion I found my "sanctuary" was in the Wairoa Gorge where we used to swim naked in the rushing stream. My meditation found me swimming with a beautifully coloured fish. It was here I had realised my marriage was ending. After sharing the experience I was asked if I would write a case study about the benefits of my therapy if any.

I came to the conclusion that the resulting release of trauma experience was more to do with

the safe place than the actual therapy. Although the therapy might serve to release the tension, it did not account for the stimulation of past memories. Nor did it account for the apparent healing process that might occur in any case given time. The O.T. was grateful for my input, and the therapist found my survey of the method she used very useful.

"How would you like to come to the Day Room for a fish and chip supper? It’s the Friday Club!"

"Good idea! And are there any mince pies in the fridge left over from Christmas? And what about a nice Guinness to go with it?"

One of the aides was sent out to order the fish and chips and someone looked in the staff fridge for the beers. There was no Guinness but there were some tins of lager!

"Thought there would be!"

We enjoyed that meal more than any other and the lager served to sweeten our cockles so much that we suffered badly afterwards from bloated stomachs! It was worth it when we realised someone would be missing their midnight stash in the staff fridge!

At the Breakfast Club one of the men was given the task of frying the bacon and making toast.

This fell to a Canadian fellow who had been badly affected by his stroke and was finding the proximity of women in the ward difficult to handle. I understood he did not like them very much. Being able to hide behind his chef job suited him very well. He did not need to communicate. Another very large man had problems with his knees and went around in a motorised wheelchair. I decided that when I went home I would get myself some sort of electric conveyance to zoom around in.

When the bacon sandwiches were made, nursing staff appeared from nowhere and we all had seconds and thirds in no time at all. It made a very welcome break from the cereal and toast on the ward. Returning to my bay, I noticed that the curtains were drawn around most beds, with noises of straining and the smell of a dirty public toilet. For some reason no one thought of opening a window or spraying with air freshener. I made liberal use of my lavender body spray to counteract the dreadful pong. Suddenly the bay was declared in isolation until it was confirmed that there was no infection. Doors were closed, staff dressed in special clothing attended us and deep cleaning was put into practice throughout. I did not like to suggest that the stomach upsets might have been caused by the fish and chips and liberal lashings of lager!

"We are doing something different today. We thought you might like to make some cakes. A lady has come in specially to help, so be in the Day Room at eleven".

Half a dozen men and women sat around a table with an assortment of bowls, spoons, knives and ingredients. We were making currant buns, and the enthusiastic tutor handed out jobs for us to do.

"You soften the butter with the sugar!" I somehow managed to hold the bowl against my chest while mashing the butter and sugar together with a fork. "Next pass the bowl to the person beside you and they mix in the eggs". Someone had deftly broken eggs into another bowl and whipped them. "Now pour on the flour and currants!" The bowl was again handed to the next person and then to the next until everyone had had a turn. Finally the mixture was stirred and spooned into paper lined muffin pans.

"While they are cooking we can have a coffee" she beamed, thoroughly satisfied and pleased with our efforts. Surprisingly the buns were very tasty and one of the women took great delight in handing them around the male bay. We said that we would make chocolate brownies

next time and maybe even raspberry muffins.

I made several trips to the physiotherapy room where I was shown how to reach across a table and try to bring a glass up to my lips. This was a silly exercise because I could not even lift my arm to table height let alone as high as my face. My arm was manipulated at the shoulder to try to release the tension but the message was not getting through.

"You are going to try walking today!" Oh wonderful!

"But first we have to see how steady you are on your feet!"

"See if you can reach this quoit!" The physio held it up high just out of reach. Whoops!

"Can you reach it this side?" She held it up on my left side so I had to reach over to get it.

"Now while I hold your legs steady take one step forward", the male physio held onto my legs feeling what muscles I was using. He and the rather overly focussed female took up a running commentary as if I was some kind of animal specimen, making suggestions about what was normally expected but how some patients made adjustments to allow for their own body function.

"It all depends on how you hold your tongue!" I said.

"Oh really? I have never heard of that before!" The very serious woman regarded me with disdain.

"Yes!" I said and poked my tongue out of the right side, the left side and the front of my mouth, but I don't think she got the joke!

Slowly I was allowed to take steps on the parallel bar ramp and then walk backwards to the start. The male physio had me lying on a treatment bed while he manipulated my left leg to stretch it. Some of the positions made my hip crunch painfully.

"I have loose joints" I tried to explain. It was like talking to a wall.

"Have you had hip replacement?" he asked.

"No, but I soon will have if you keep that up!"

"Can you lie on your stomach?"

I had not even tried. It was enough trying to roll over on my side. You have no idea how almost impossible it was getting my dead arm out from under my body. "Now lift your feet up and bend your knees!"

I remembered how nice it used to be lying on my stomach on a towel at the beach with my feet waving in the air and watching the beach boys surfing. But how difficult it was now to even lift them off the bed, or make my legs bend. Maybe that was something that belonged to the past now.

"We think you are ready to walk with a stick!"

A beech wood stick was cut specially for my size and I practised walking slowly up and down the room, anxious not to falter and maybe lose my balance. A carer walked with me holding onto the belt at the back of my pants.

Because I was still suffering from painful muscle spasms I was taking a muscle relaxant. In the morning it made me feel as if I was drunk, and walking down to the bathroom with a carer holding onto my belt with one hand and the other supporting my left buttock I felt decidedly delirious. I just cracked up, which of course ended with me wetting myself, which made it even funnier. Once again no one else seemed to see the funny side of it, and that made me laugh even more.

"We want you to do a psychological test!" The O.T. said importantly, waiting for my response.

"Sounds like fun!"

"We want to see if you can make decisions!" Anything to relieve the monotony of watching the women in the beds opposite.

I have always enjoyed problem solving puzzles and crosswords and I once did a MENSA test and was asked to join them. My intelligence level was in the top 2% so I was pretty sure this test would be a breeze.

We sat at a table in the Day Room and I was handed a number of problems to solve. Taking stock of the whole scenario I took a few minutes to form a strategy and then told the O.T. my answer. She seemed impressed that I had taken time to evaluate since most patients apparently just went ahead and did not think things out. I told her that I generally looked at the whole picture and often had a five year plan of action. It gave room for change if things were not working to plan, and have a plan A as well as plan B or even C. I got a 100% pass rate that confirmed I could still solve problems!

Of course all this concerted effort was to assist in getting my discharge from the hospital and possible return home. What actually happened was a referral to a rehabilitation unit in a Care Home. Something I had not planned for.

TWELVE

"there is no difference between a disabled person and one with two arms!"

The Social Worker bustled into the ward in a flurry of smart clothing and perfume, clutching a wad of pamphlets and a voluminous notebook. She was one of several intermediaries between the care groups and the hospital that sent out loads of helpful advice and information booklets.

What I was looking for was some action. Information was coming out of my ears in volumes like indigestible mush. She smiled reassuringly, coming in close for a confidential chat.

"Just how do you see yourself in a few years time?" I don't see myself anywhere actually.

"Well I understand that it takes at least two years, even three to recover from a stroke. It may not happen immediately, but in any case I'm not getting any younger!" I explained . I MAY NOT EVEN BE ALIVE IN A FEW YEARS TIME. "One has to be realistic!" She looked at me wide eyed.

"You certainly have a good outlook anyway!"

Outlook nothing. I have a failing heart as well, so my prognosis isn't all that good.

"I might end up in a Care Home but I'll meet that when it comes. It's possible that I will move to sheltered accommodation, but at present I cannot afford it."

"Oh, well you can receive attendance allowance, or disabled allowance. You need to apply for it now. I'll leave you some information about it." She wrote copious notes in her personal record as well as my home address and how to get in touch with my daughter.

"Here is my card, call if you need any advice!"

Its action I need, NOT ADVICE! Wafts of perfume pervaded as she hurried out.

I never did learn to identify each of the social workers who came to give me wads of information brochures about after stroke expectations, heart failure and elderly care homes.

One of them told me that there was a Stroke Club where patients could meet socially but not where it was or how to get in touch. I was told that it took six months to qualify for an increase in my Guaranteed Pension Credit and to apply for a Disability Allowance, but nothing was offered as to how this was activated. A Social Worker would come to see me when I returned home, and no doubt things would become clear then. I was learning the value of patient stoicism!

It came as a shock to be regarded as disabled. Surely my condition was a bit like breaking a leg and eventually I would be able to walk smoothly as before without clumping my foot as if I were avoiding a mess on the floor. I thought I would soon be able to manipulate a fork in my left hand or at least be able to lift my arm high enough to wash under my armpit. I had already realised it certainly was not something one recovered from to wake the next day to find all was well. Not at all like 'flu', or tonsillitis or any childhood disease. I remembered my son's friend who had had a nasty crash on his motorbike and ended up with brain damage that severely affected his left side and rendered him paralysed. He used to fall a lot and scald himself in the shower, but it had not stopped him from travelling overseas, getting a job, marrying, and getting back on his bike. But mine was a stroke, not a road crash; not the same surely? It took several more weeks before I came to terms with it.

A very well dressed woman liaison officer between the hospital and one of the council care homes visited and handed me a brochure. The facilities offered appeared to be comfortable and well run, newly built, with all mod.cons and individual bedrooms with en suites. There was physiotherapy several times a week, and 24-hour care. However the full time staff was reduced at weekends and a skeleton staff on at night. I handed all the mounting pile of information to my daughter for her to peruse. I just found it all too much to digest. Apparently these different people were being paid large salaries to dole out the same information booklets,

magasines and pamphlets all in the mistaken belief that it was a valuable service to disabled people. I had already picked up several of the booklets and brochures on my visit to the cardiac unit weeks before, so did not need the same diagrams and mutter words describing my state of health over and over again. What I wanted was someone to arrange for some valuable assistance when I got home, and even better someone to give me help in being able to use my arm and leg properly so that I could do things for myself.

"Let me see how far you can lift your arm!"

"Mmmm! It looks as if you need a wrist support. Do you suffer from arthritis?"

If I have a support on my wrist wont it stiffen the joint?

"You have swollen ankles still. We will keep an eye on it. Maybe we will Xray your wrist and ankle. Perhaps the swelling will go down once you are mobile!"

"I have had a deep bruise on my leg ever since I had the stroke and my big toes are being cramped in the support stockings and are swollen".

"Mmmmmm!"

I noticed that my toe nails were not growing either. I guess in contrast with many elderly women my feet and legs were very good, but I knew what they ought to look like.

"A stroke can cause lots of things to happen!" There, there silly woman you will be out of here soon anyway!

"I broke my ankle several years ago and it was pinned. Do you think the pin was dislodged somehow?"

"Can you move your toes? Does it hurt?"

I can move my toes but I can't move my foot! All of me hurts.

"Once you are mobile, everything will settle down!"

I had not worn a bra since I came into hospital. I had had a mastectomy several years ago and it was virtually impossible to fasten a bra with one hand without having to insert a prosthesis as well. So I decided not to bother. However I asked if I could see the breast care nurse to ask if she had mastectomy bras that were easier to put on for people with one arm. This request had been made weeks ago but with little result. Now finally I was taken down in my wheelchair for a consultation.

"I do not really understand what it is you are asking for!"

I explained what my needs were and the woman stared thinking I must be mad. A wide selection of mastectomy bras were hanging like forlorn washing in a unit beside me. She did not offer to show me any.

"Surely the O.T. has given you instructions on how to put on a bra?"

"Yes, but I wanted to know if there was anything more appropriate for disabled mastectomy patients".

She continued to stare at me with obvious bemusement. The problem was beyond her comprehension.

"There must be a niche market I would think for something like this. Mastectomy bras have a pocket insertion in which a prosthesis fits, so that it is a snug and comfortable part of the garment. I can't be the only person with this problem. My left hand wont hold the fastening long enough to attach the hooks into the eyes! Besides I cannot do it up behind my back and I am not strong enough to pull it around to the front. If I had a front fastening I am still not able to do up the hooks and eyes!"

"Would you like me to write down what you are looking for?"

She handed me a booklet of mastectomy fashion garments, suggesting I might find something

within its glossy pages. She wrote an essay about my problem! It began "A disabled person is no different from a person with two arms…" I guess there was a peculiar form of logic in it!

THIRTEEN

"it will help you get used to being at home!"

I had been in hospital for six weeks and was able to walk along the corridor in jerky movements like a marionette. My grandson said I looked like a Thunder Birds puppet.

Everyone seemed very pleased with my progress although I was somewhat disappointed not to have progressed even more. Obviously the aim was to get me up so I could be moved on. Beds were in demand and I was technically mobile.

"You have been booked into Maiden Castle Rehab for six weeks! It’s a new building, very modern and really posh! You will love it there. You have a room all to yourself with an en suite. Physiotherapy is several times a week. It will help you get used to being at home!" I don’t feel pleased. I would have preferred to go home straight from hospital.

"You live alone and so it has been decided that you would be better in the Care Home Rehab and then your home can be assessed to see if it is suitable for you to return to!" I feel institutionalised already. Was this the sort of action I had been looking for? You have to be careful what you wish for!

My friend was going to another hospital nearer her home. I gave her a card with my address on it and to say thank you for being a good companion. Although I wrote to her afterwards, I never had a reply. The same was true of other contacts I had made. I guess people just get so involved with their own lives they don’t bother with other people. Probably don't want to be reminded of what sort of hell the whole experience was anyway.

My daughter packed up all my things into a small overnight bag, several plastic bags and a small case. It was incredible the amount of things I had accumulated in the short space of time. I wanted to go home and see the spring flowers in my garden, but instead I was being sent to yet another organised setting. The idea behind it was to get into a routine similar to being in one's own home. Of course it did not allow for the fact that it was nothing like one's own home, nor that some people abhor routine! Living alone freed you from keeping any kind of schedule. You had meals if and when you wanted them. You got up if and when you wanted to and you watched television any time of day and night if you felt like it, without anyone objecting or demanding or putting you on the spot. Lovely!

Nurses and doctors came to say farewell and Dan the Man gave me a cuddle. I was wheeled down to the Discharge office to wait and then expected to walk up the ramp into the ambulance. The Care Home was a short drive away and I walked very unsteadily into the reception hall. I suppose it depends on what sort of environment you have been used to but in spite of being told what a wonderfully posh place it was, it seemed to be rather Spartan.

Minimal and modern I suppose. My home is a comfortable cottage and I could not see how this place could possibly help me to acclimatise to being in my own home. All it did was make me get used to yet another environment. I did not need it and felt depressed.

There was a central laminate floor with a surrounding carpeted area. Pine wood dining tables and chairs sat in neat rows on the laminate floor and individual rooms radiated out from the carpet walkways. At the far wall from the restaurant were a circle of casual arm chairs with high backs, interspersed with coffee tables. It was designed to look sociable but all it did was look isolated. The focal point was a large television. Apparently the chair seats were of varying heights, specially measured to fit leg lengths. However the seats were longer than my legs, front to back, so that I either had my feet off the ground, or I lay back uncomfortably like a couch potato. There was nothing to do except stare at each other or the television.

My room with en suite was at the furthest end of the walkway, near the exterior door. It was on the cold side of the building, with no sun. The en suite was a power shower wet room with wash basin and toilet. I was told showers would be confined to once a week.

My bags were dumped on my bed and I was left to unpack myself. The adjustable electric bed sat squarely in the middle of the room, with a large wardrobe near the door and a wing chair squashed between. A chest of drawers was placed under the window. It looked extremely patient unfriendly.

I discovered most of the males and females were hip or knee replacement patients and I was the only stroke patient they had had for a long while. It took the carers by surprise and I felt they did not really know how to help me adjust. I was handed a letter advising me that I could stay up to six weeks free of charge but after that I was expected to pay the normal fees. It was written on Council notepaper. It had been government policy to privatise certain parts of the caring industry under the umbrella of the local councils and the N.H.S. leased this rehabilitation centre. It ensured that the centre always had an income coming in, and from fourteen potential patients at £600 or £700 a week it was a highly lucrative scheme.

The private Care Home itself was a very well appointed and luxurious looking place reached through a series of security doors. It had a large enclosed patio with floor to ceiling windows opening out onto it, and several lounges with comfortable couches and chairs. The rehab felt like a poor relative and I was sure that some of the staff felt that because we were subsidised we were not entitled to the same treatment. This was particularly true of the three night staff who were expected to look after seventy five patients in the whole home, some of whom suffered from dementia.

"Hello! I am your staff nurse!". A jolly hockey stick sort of person jigged from one foot to the other, posturing in a legs apart stance.

"I will be looking after you during your stay and keeping an eye on your progress".

She handed me a sheet of paper on which was written a progress chart for the coming week.

"It's to give you an idea of what to aim for!"

This sounded encouraging. ""We serve breakfast at 8.30, lunch at 12.30 and supper at 5.30, with morning and afternoon drinks. We like to have you dressed and seated at breakfast, so that you get into the routine you have at home!" I never dress before breakfast and probably don't eat before nine in the morning anyway!

"Visitors can come any time they like and you can also go outside if you wish as long as you let us know at the office!"

My daughter and grand son arrived and admired my room. They brought flowers and fruit and magasines, some cushions and a knee blanket. It made it feel more comfortable and when, after several days, the staff nurse said I could turn the room around to suit my needs, I was

able to make it far more user friendly. Several other patients saw what I had done and changed their rooms around as well. Some of the care staff were very put out when I wanted to use the foot stool as a dressing table seat and put my medication in the top drawer of the chest of drawers instead of a locked drawer in a night table. As it was the locked drawer had no key!

However I won the day by saying that it was more patient friendly instead of staff friendly that way!

My daughter had bought me a mobile phone for Christmas and so I was able to text my sons "Down Under", and listen to the radio on it using earplugs. I also persuaded the staff to put up a table so that the patients could do jigsaw puzzles, and unpack some books that were stored in boxes and put them on display. Other games were found as well so that patients could do other things than stare at the television all day. Why it had never been done before was a mystery. As for twice weekly physio, it was a joke.

A smartly dressed woman entered my room and beamed at me. "I am just checking to see what you can do!" Pardon me?

"Show me what you can do!" In relation to what?

"Did you get given some exercises in hospital?"

"Oh yes, of course. Do you want me to show you?"

"Yes!" I went through the routine.

"Very good!"

I added some little extras, like standing on my toes holding onto the hand rails in the corridor.

"Mmm! Yes!" I never saw her again.

Once I got given some large quoits that had to be placed in squares in a huge upright contraption.

"Lets see what you can do with this!"

I was supposed to grab them with my left hand and lift them up to fall into the squares Because I could not lift my arm up beyond waist height I passed them to my right hand. I suppose it did some sort of good, though unless my arm was manipulated to release the tension in the muscles, it seemed pointless. Besides it was extremely painful. I was also given an exercise where I had to reach across the dining table and bring a salt shaker towards me.

The idea was that it would strengthen my ability to use my left arm and hand. If nothing else, it caused a lot of amusement with the women sitting at the table with me, especially as I had to lean right across the table, using my right arm as a support.

My eldest son in New Zealand had wondered whether to come over to England to visit and do something to help. We agreed that it would be a waste of time since I was being looked after in hospital. However my daughter thought it would be a greater help if everyone pitched in to pay a gardener to do some landscaping to my design so that I did not have such a lot of work to do in my cottage garden. I already had a small circle of grass, a frog pond and a spacious patio, with beds of perennials dividing the outdoor rooms. So I redesigned what I wanted removed and extended the grassed area, setting out a schedule for the gardener to work to.

The care nurses were intrigued that I could remember the names and position of the plants and trees in my garden! "Well, after all, I designed it and planted it myself from a strip of grass, so I should know what I've got in it!" It was all to be done by the time I got home, hopefully by Easter.

There was great excitement as Saint Valentine's Day dawned. Our dining tables were decorated with bouquets of red roses and small boxes of chocolates from the Care Home.

At lunch we each had a glass of dry sherry as an aperitif. It was a very special treat.

The next day my daughter and grandson visited in the evening and I told them that my left hand felt very sore as if it had been stung by nettles. It was swollen, and so were my ankles.

My head felt heavy again and a sort of hum seemed to be on the right side of my head. My heart was pounding too and I was getting short of breath again.

"Have you told anyone?"

"Yes I told the care nurse, but who else can I tell?"

"This is awful! Your arm should not be like that!"

My daughter rushed down to the office and came back with the Charge Nurse who said that she did not know what to do as it was outside her expertise. She rang for a paramedic from the hospital and once more the room was full of efficient and jolly young medics with oxygen bottles and all kinds of equipment stored in back packs and cases. I was attached to an electrocardiogram, and the readout described to my grandson, who stood watching everything in awe. Loaded with equipment and a case of clothing I was wheeled on a stretcher through the restaurant where everyone was waiting for dinner to be served. "I wont be long!" I called out to the ladies at my table, feeling decidedly stupid and vulnerable, with my daughter and grandson trailing behind. I was lifted into the ambulance and my daughter told the medics not to give me a saline drip as this had caused untold problems before.

Once more the procedure was followed with an oxygen mask, a heart monitor and a two capped needle thrust into my left wrist. I was given a name band and hospital number on my left wrist, and leads attached to various points on my ankles, legs and chest. This time I was fully awake and without a chest pain. Apparently my heart was flopping about sufficiently to cause alarm, and needed stabilising. We arrived at the Emergency entrance and I was wheeled into the cardiac bay where the same female black doctor assessed me.

"Back again?" Looks like it.

"What have we got this time?" You tell me.

"Mmm! Well we'll just monitor you for a while. You are very low on oxygen so we'll up it a bit. The medic did not realise that your heart behaves like this normally!" She breathed a sigh of resignation and went to look up my history on the computer.

It seemed like hours went by with nothing much happening. The black doctor seemed to be more interested in discussing an up and coming wedding and what she would wear for it. She was obviously very excited about the event, looking at photos and talking about the location, giggling and chatting away with my file open in front of her. Looking through the open curtains I could see that the bay was really very shabby, and obviously in dire need of repair. It looked well used. Eventually she turned her attention to me.

"You are going up to the Stroke unit again!" Oh joy!

Apparently I had unfinished business there.

FOURTEEN

"Liff wee oop!"

I shared the Acute Stroke ward with an odd assortment of disoriented and deranged males. It sounded like a lot of distressed and caged wild animals. Next to me was a poor woman who was in a coma whose limbs were twisted in knots. She was mostly ignored by the nurses.

From somewhere down the corridor a woman kept shouting that she had to save her baby because they were going to kill it. She sounded very upset and her shouting grew steadily more and more intense.

"Oh goodness, Angela what are you doing here?"

I made a facile remark of some kind. The familiar faces looked concerned as the doctors looked through my old notes.

"Mmm! A scan I suppose. You might have had another small stroke. We will have to see where it is this time. Can you walk?" Yes a little. The Warfarin medication was stopped and I was given another drug as well as Aspirin to reduce the possibility of a more severe stroke.

I was injected with a large amount of solution to reduce water retention, and attached to a twenty-four hour heart monitor, that thankfully ticked along happily without making tragic beeping noises. I slept fitfully to be awakened by the roaring of a male patient at the end of the unit. I later discovered he was attempting to cough.

Coming back fully conscious to the Acute Stroke unit gave me a chance to see exactly what went on there. The attention and care was truly amazing with all the staff nurses in attendance. I was checked every few minutes for blood pressure, temperature, heart beats per minute, breathing, and oxygen levels. It was obvious that this was where the business of patient care was of top priority and by the time a patient was put into rehab. they were considered to be on the road to recovery. This was where team work came into play. It also became obvious that I was not as acute as many others in the unit. I could walk for one thing, and so I could use the bathroom. It took a great deal of persuasion to get the nurse to understand that I did not need a bed pan or a commode.

Once more I was wheeled down to the CAT Scan, but this time I was able to stay awake to see

what was happening.

"Yes you have had a minor stroke. The clot is quite small in the right radial in a different place from last time, but very deep. Having an irregular heart beat does not help! We will keep you off Warfarin for a while until it disperses and see how it goes. We want you to have other tests to see if you have clots lurking in other places."

By now I knew the routine, the regular doctor's conferences and bedside chats, the checks and progress reports, the gatherings of staff at the Bridge. My notes stated that I had settled back into the ward happily, falling into the routine as if I had never left! Curiously however I could not yet feel any effects from this most recent event apart from a tingling sensation down my left leg and aching in my left arm that reminded me of mumps.

The surreal feelings I had had when I first came into hospital had diminished with familiarity, and I was able to reassure the new arrivals that they would recover and eventually be able to walk as I had done. It was extraordinary watching while extremely paralysed people were encouraged to sit up and balance and got ready to wash themselves. The capitulation and horror of loss of power by the male patients was disturbing. One particular man spent most of the time staring at the bandages that were holding his drip tube in place on his wrist and attempting to remove it. He was obviously bewildered by it and examined it from all angles trying to figure out what it was.

The man opposite me lay perfectly still and almost to attention. He looked frightened to move, and his wife took up a vigil by his bed all day and into the night. She stopped overnight in a make shift bed in the Day Room and looked as if she intended to stay with him until he recovered. It was also strange hearing him tell her about the reflex action of his hand when he yawned. I wanted to tell him it was quite a normal thing to happen. Next to him was a very noisy man who no one understood. He was incredibly restless and seemed to be too tall for his bed.

"Liff wee oop!" he shouted "Cubba wee oop!"

"Wee Wee, oh liff wee oop!"

After a while I realised that he had worked his way down the bed and was squashed at the end. He had thrown off his blankets "Wee cowlt!" he complained in a childish whining voice.

It turned out he was Russian and although he had lived in Britain for a long while, he still had a Russian accent.

He was like a character from a Chekov play. Putting on a drama he announced "Wee baralised.

Wee vant to die!" His deep voice resonated throughout the ward and in frustration I explained to him all the ways he could probably bring about his own death.

"It wont be a happy death. It will be very painful. What you could do is let yourself get cold and not call out to be covered up. Or you could let the pillows fall over your head and not ask to be lifted up. Or you could stop eating or drinking. I bet as soon as you realised you were dying you would fight to stay alive. You will get better, because I was like you and I can walk now." He did not believe me.

Further down the room was a little old man who kept wriggling so much he fell out of bed in spite of the safety railing. He seemed to be able to wriggle through it. Igor rescued him and his bed was lowered to floor level and pads put beside his bed so that if he fell he would not hurt himself. The nurses built a sort of cage around him with safety pads. In the daytime he was put in an orthopaedic chair but he wriggled out of that too. Eventually it was agreed that he was too much of a liability and he was sent to another ward.

The staff nurse on that night was the same one we had sung "Why are we waiting?" to. I suggested that the pads looked like the landing pads for gymnastics and she should do a forward roll and land in an arms outstretched finishing position. So nothing daunted this rather portly nurse took a running jump, faked a flip and stood on the pad with arms up "Dadum!"

It once more became a talking point for days to come at the Bridge at handing over time.

One of the tests I was given involved strapping a recording mechanism to my chest to take note of changes of heart rhythm. Over a period of twenty four hours I had to make notes on a form about any changes I might feel or my state of mind. One of the comments I made was the frustration at not having anyone to assist me to the bathroom. Although I could walk I still needed someone to walk with me in case I tripped or got my legs in a twist. The "be back in a minute" mantra often took half an hour, by which time there was extreme urgency. I overheard one care nurse say she did it purposely to encourage the patient to help themselves.

Another test was a gadget attached to a monitor that traced the movement of blood through arteries in my neck to my brain to see if there were any obstructions. Apparently there were odd bits still lurking around. "You will probably experience an occasional little event every now and then!" Thanks a lot!

Because my left ankle was still very swollen, the arteries and circulation in my leg were examined by a peculiar method of running a gadget over my leg and squeezing the flesh. The monitor showed up patches of different colours that indicated blood flow. All seemed to be normal. "It will all settle once you are properly mobile!" When will that be?

I was probably only in the Acute unit for a few days and then was moved to the rehab unit with a lot of other women and a man who had difficulty breathing out so that it sounded as if he was laughing. The care nurses thought he was hilarious and joked with him so much that he ended up in paroxysms of gruntings and roars like some wild boar. He had a group of buddies who visited and laughed along with him. It was not until the speech therapist came along to assist him to breath that I saw his problem. His mouth was fixed in a grin as well which gave the appearance of laughter but in fact he was probably feeling the opposite.

The lady opposite was quite young but very depressed with her situation and refused to make any eye contact with her family when they visited. She appeared to be punishing them and her over attentive husband for her condition. She was also unable to speak, and was not able to understand pictures or letters to describe her needs.

There was panic in the ward when it became known there was going to be a spot check on health and safety. Odd assortments of equipment and clothing dumped on windowsills were removed, tops of curtain rails were wiped, ledges were cleared and wiped over, and skirting boards were washed. We had to clear our bed tables of accumulated junk. Some patients seemed to store unused cartons of juice and yoghurt. When after a while the check did not appear, it soon became untidy again, and of course this was when the committee arrived.

After another few days it seemed I was well enough to return to the Maiden Castle home. My bags were packed, I was put in the ambulance and wheeled back to my room.

"You are to start from day one again. Here is the outline of what you can aim for this week.

You can stay for up to six weeks free of charge but after that you have to pay full fees. Nice to

have you back. Is there anything else you want?" Yes, a good night's sleep!

FIFTEEN

"I'm not going to put up with it!"

"We are going out on the town!" My daughter had arranged to take me out in a wheelchair to the shops. "It's like going back to taking the kids out in a pushchair!" she laughed. Tucking me into a blanket and squashing a knitted hat on my head, she tried once more to persuade my left hand into a glove, without much success. I once more collapsed into near hysterics at the ludicrous situation. I felt like a bundle of old clothes. But what joy to be out in the cold fresh winter air.

Being trundled along in a creaky old wheelchair made me realise just how disability unfriendly the streets were. It was difficult manoeuvring the chair over the paving stones that were laid at a crazy camber presumably to enable rain water to drain into the road. It was hard to find ramps with the kerbs at road level low enough for safe crossing. Some shops had no ramps at all and ladies hairdressers were invariably reached up a flight of stairs. The paving in some of the arcades was very decorative but impossible for a smooth ride in a wheelchair or electric scooter. Some of the old cobbled passages were also very dangerous with sloping sides and gullies for rain water.

We sat at a table squashed between other patrons and enjoyed a steaming cup of latte coffee and a patisserie. It felt civilised. I was pleased that other people smiled at me and were anxious to help us get past the tables and chairs. I was taken to a shoe shop and tried on a pair of bright red Reikers with Velcro straps. I also bought a pot of daffodils for my room.

The gardens along the road were full of Spring blossom, with daffodils and polyanthus, pansies and grape hyacinths in abundance. It was hard to believe it was still only February. Back in

my sunless room, my daughter placed the pot of bright yellow flowers on the table by my chair.

The perfume filled the room and Spring was brought indoors. What a glorious sight!

I had a steady stream of visitors and the assistant minister from my church was a regular visitor. It was truly remarkable how attentive they all were and it was really an insight into how caring people were, some of whom I hardly knew. My recovery was greatly enhanced by these wonderful people, their cards and prayers a constant flow of energy, uplifting my spirits.

At the lunch table there had been a change of patients. The rather loud and jolly Dorset man in the room opposite had apparently been taken back into hospital. His condition had been very strange with a very painful arm. It sounded a bit like blood poisoning. He was very deaf so conversation was a bit one sided. When he leaned forward to eat, his hearing aid whistled!

He said his late wife used to get annoyed by it. His grand daughter used to visit regularly and I could hear him telling her stories and she would say "You are naughty grandpa!" He was amazingly cheerful and always laughing. Sadly he died in hospital.

We sat six to a table. The lady at the head of the table was very crippled with arthritis. She needed a lot of help to dress in the morning but was always cheerful as well. Opposite me was a very large and loud Dorset woman who had amputated legs from severe diabetes. She was so large that she required a huge motorised wheelchair that just fitted under the table.

Everyone seemed to know her and apparently her family had lived locally for generations.

Used to lots of attention she always seemed to require the care nurses at inconvenient times to hoist her from her chair or bed onto the toilet. The clatter it made at night was horrendous and I got really stressed being wakened at three in the morning every morning with shrieks of laughter and loud conversation and the banging of the hoist against the walls.

One night the noise was so great from the care nurses chatting and laughing in the kitchen that I got up and asked if we all should be up and awake now. I walked unsteadily, in my night gown, along the carpet walkway to where they were standing, with them gawking at me open mouthed.

"What?"

"I said, you are making so much noise, I thought it was time we all got up!"

"What?"

"Would you mind keeping your voices down? It is unacceptable to be woken at three in the morning with so much noise!"

"What?"

"The noise you are making woke me up and it is no joke!"

"Well we can hardly go into the room and not say anything!"

"Yes, I agree, but you don’t have to shout or be so loud. Cant you keep your voices down?"

I walked back to my room with the three nurses mumbling something about impossible patients.

The next morning I got a visit from the Charge Nurse to say that my neighbour had been very upset by my complaint. I said I was upset too, being woken constantly in the middle of the night with so much noise.

Another woman at our table was obsessed with her medicine tablets. We were expected to medicate ourselves and had been given special bubble packs so that the right amounts could be dispensed at the right times of day. This lady preferred to have them in packets so that she could work out which ones to take. She had them all arrayed in front of her and peered at

each packet and counted them out over and over again. In the end I could not stand it and went and sat in the lounge area until our breakfast was served. In the end she went and sat on her own at another table so that she could have all the packets out in front of her. The care nurse tried to help but she would not listen and rearranged everything again.

For some unknown reason, the night care worker felt it necessary to poke her head around my door at five in the morning to ask if I was alright. She said it was to discover if I was dead.

How she imagined she could tell from that distance I do not know! One night I asked her what her duties were. She was immediately on the defensive, saying that I was not the only person she had to deal with.

"No, I realise that. I was interested to know what you were expected to do, and if you enjoyed your work." She seemed such a sour faced person, I thought perhaps she hated her job. ""Well, some people are very rude you know!"

"Are they?"

"There are just three of us on duty to look after seventy five people. Those upstairs are dementia patients, and we look in on each one throughout the night. We have to prepare the kitchens ready for breakfast and clean up the floors. I enjoy it and we make a good team!"

"You must be very tired by the end of the shift."

"I have been working nights for years. I have a disabled husband as well so it fits in well."

At the end of each night shift at six thirty the care worker came and asked if I would like a cup of tea. Invariably I would prop myself up in the adjustable bed and wait, and wait and wait.

Sometimes the tea would arrive about an hour later and sometimes it would not. The morning shift was one extremely hyperactive little body who ran everywhere like the White Rabbit in Alice in Wonderland. Sometimes an O.T. came in to wash and cream my legs, soak my feet and change my compression socks. That seemed to be his sole job. The long white compression stockings had been exchanged for knee high green ones referred to as TEDs. The socks were very tight and squeezed my toes and feet so much that I was sure they caused my ankles to swell. My toe nails were not growing either and felt very painful.

After having the second stroke I was told that I had to report the slightest change in my condition no matter how slight. So when I felt dizzy or pins and needles or tingling sensations I told the Staff nurse. It was supposed to be written in my progress report. However when I said to her that it was important, she said that she thought I was just making general conversation.

"Its okay dear!" she explained pointing to her head. "Its all in there!"

One of the O.Ts from hospital came to see me along with a student who was finishing her third year at university. They examined how well I could use my left hand and arm and gave me some exercises I could do. My arm was manipulated to release the tension in the muscles, and after discussing my condition between themselves, I heard the O.T. say that she thought the nerves were damaged and it had been left too late to make much difference. It was not something I wished to know. Surely I would eventually be able to get my arm working sufficiently to lift and carry objects. After all if I had to walk holding a stick in my right hand, how could I carry a cup or plate to the table? I tried to think of a devious plan.

On one occasion three care workers came in to change my socks. I had shown the trainee O.T. the correct way to put them on, that I had gleaned from the packet of compression stockings I had bought in the local chemist for use on long haul flights. The method was simple. First find the heel and pull it through the stocking, pull it over the foot and then pull up the remaining

stocking over the foot and up the leg. The care worker in charge would not listen and tried to stretch the stocking in both hands pulling it over my foot and ankle, her knuckles digging painfully into my weak leg. She started to shout at me that she knew what she was doing, so I put the other stocking on easily using the correct method while she was still struggling to get the other one on.

"Oh, look she is doing it herself!" she shrieked, throwing the offending stocking on the floor in a tantrum.

"Don't you dare talk to me like that!" I said through clenched teeth. She rushed out of the room.

It must have been the second week when a couple of O.Ts brought a large bouncy ball into my room and placed it against the wall in the corner of the room.

"See if you can sit on this without falling over!" No problem!

"Oh, yes, she can do that easily. Now lift your arm up above your head!" Why not give me a difficult thing to do!

"She can do that too!"

Although it was written down in the progress report that this exercise should occur regularly, that was the last time I saw the big bouncy ball!

A hairdresser came every Thursday and I decided to pamper myself by making use of her. She was very professional and cut my hair beautifully for a very low fee. She played old tapes of Glen Miller and Tommy Dorsey, and all the old wartime crooners and sang along with them. It was something I really looked forward to. When I left she said she would miss me. I was surprised, but she explained that out of all her clients there, I was the only person she could converse with. How sad.

The ladies at my dinner table commented on how quickly I ate my meal. They always behaved as if they were sitting in a posh restaurant, taking tiny and delicately balanced titbits from their plates. They seemed to spend ages gathering the food onto their forks, whereas I was having to use my fork like a shovel, the American way. They suggested that perhaps I did not chew my food. In fact I did, but I probably put more of it in my mouth. I noticed that most of them did not have their own teeth, so it might have been that they could not chew so well with gappy mouths or loose fitting dentures. One lady with black and stubby teeth, most of which were missing, was aghast. "I have my own teeth!" she announced.

I started to do a comic act, pretending to be a rather timorous old lady, with a failing memory and a quivering lispy voice. It was similar to the Peter Sellers skit of the aged couple in The Goon Show. I banged my stick on the floor and said "I'm not going to put up with it I tell you!

I can't stand it any more! What. What, What was I saying little boy? Oh dear, um, what? I think I was going, ah, what? Um, ah, not going to put up with it any more!"

It caused a lot of merriment at the table, especially when I pretended that I was counting out my pills, and forgetting where I had got up to. On this particular occasion there was a new care nurse on duty. She must have gone and reported my behaviour to the Charge Nurse because she came bustling down and asked me to come with her to my room.

"Do you think that because of your condition you are perhaps over reacting and out of control?" she asked. "Someone said that you had stalked off from the meal table in a temper!"

"Not unless it was the other day when we were still waiting for breakfast at nine thirty and I got tired of waiting!"

"Is there something you want to discuss?"

I could not see myself stalking off when I could only walk very slowly and unsteadily anyway.

"No, I feel perfectly alright and under control. I am not the sort of person who loses my temper! You can ask the other women at my table if I am that kind of person."

I guessed that the new care worker had taken my parody seriously, but I did not enlighten the Charge Nurse! Shame! I wondered just who was over reacting!

A very officious nurse had come on duty one morning and could not understand why we all expected to be waited on. "I am a care worker, not a waitress!" she announced, then having made that plain, she asked who wanted tea and who wanted coffee. I called out "Tea"!

"What do you say?"

"Tea!" "Don't you say 'Please'?"

"Yes, but it depends who is asking!" I retorted. Everyone sniggered.

"Thanks very much!"

"You are welcome!"

The ladies at my table said "Well done!" quietly in case she shouted at them, but ever after this the woman was very polite to me. I really am not going to put up with it!

SIXTEEN

"You are going home" Easter was early in 2008. There was talk that I would be going home to be assessed after four weeks in the rehabilitation centre. But first I had to practice climbing stairs and make a cup of tea in the restaurant kitchen.

A well dressed woman came to see me to explain in great detail what was going to happen. It all went in one ear and out the other. She left more bundles of information. Someone from the Occupational Therapy Unit was supposed to go with me to see if I could make a cup of tea in my own kitchen and assess what needed doing in my house from a health and safety point of view.

It seemed they wanted me out before Easter. There was talk of special blocks to raise the level of my arm chairs and a booster seat for the lavatory. They were worried that I did not have

stair hand rails and were worried in case I could not climb up to the bathroom. It was suggested that I had a commode downstairs in the lounge or in the kitchen. Fine, but who is going to empty it? I did not want the cosy comfort of my cottage made into an old people's home. They also wanted to bring my bed downstairs. Okay, but where would you put my lounge furniture?

I was fortunate that I had been a very strong and active person and that I had good legs and a strong right arm. Climbing stairs was not a problem and I could rise up easily from my arm chair. However the O.T. measured up the staircase for hand rails and made appropriate marks on the walls for them to be fixed. I already had a disability trolley that I had never taken back to the hospital after I broke my ankle years ago. It was in the garden with plant pots on it! I could push it into the diner from the kitchen, so that problem was solved too. I thought that I could keep one walking stick on a peg at the top of the stairs and another resting against a chair at the bottom of the stairs. Another problem solved. All it needed was a bit of creative imagination.

The hand rails were fixed and I was brought back to view it. What a pigs ear had been made of the pretty staircase, with wood rails and white plastic hand grips at rakish angles. The rails were coming away from the wall and so the carpenter had to be booked to come and fix them properly. It was unlikely that he could do it before Easter, and even then, not for a week or so after.

The well dressed woman visited me again and explained it all to me once more in great detail.

"If you stay longer than six weeks, you will have to pay full fees!" she explained.

"But surely he can fix the railings before that?"

"Well you see Easter holidays come in between and several of us go on holiday then". Nice for some! Hang on a minute, it's not my fault that he did not fix the rails properly the first time.

Why should I have to pay for his bad workmanship?

I pondered this for a while. Meanwhile there had been a shake up in the rehab centre.

"Come along, you have to come into the sitting area to be sociable for morning drink and teatime! No one is allowed to stay in their rooms."

I wandered down, annoyed to have been made to be "sociable" with people I had little in common with. All they were interested in was soap operas. If this place was designed so that we got used to being at home, I had to be able to live alone with my own thoughts and hobbies. Whenever I shared some of my interests, most people went back to watching television game shows! They did not understand my fascination with science or wild life.

Generally I either did jigsaw puzzles in the sitting area, or took my puzzle books to do.

We sat around staring at each other, and a tea trolley with mugs and a hot water jug was pushed in front of us. We had to make our own drinks! I decided not to play their silly game.

I did not want a drink, and I came to sit with everyone because I had been told to do so!

I finished my crossword puzzle, ate some chocolate and went back to my room to listen to an interesting discussion on the radio.

It had been the custom for some of the patients to have drinks taken to them in their rooms.

Some even had their meals taken to them. One poor lady who had suffered a bad hip injury had only been home for a week and discovered she was not strong enough and had come back in again. She spent a lot of time in her room, but was now being forced to join the social

group. One meal time she went back to her room to go to the toilet. We heard a terrible shriek. There was only one care worker on duty and she was busy serving the meal. After a while she realised that the lady was in real trouble. Apparently she had fallen and broken her hip again, worse than before. She was taken back to hospital on a stretcher and we did not hear what happened next. I thought she might have died from the shock, but months later I met her in Out Patients, looking trim and healthy.

A person who knew my daughter was visiting his own mother in the centre. He was very critical of the treatment and asked one day about the physiotherapy we were supposed to be having several times a week. I said "What physio?"

"Don't you have any then?"

"I have only seen the physiotherapist once since I have been here and then it was only to ask me what exercises I could do!"

"What sort of place is this then? The reason for mother being here is for respite and physio!"

"You will be lucky!"

He rushed off to remonstrate with the Charge Nurse and the others that congregated in the office of the main Care Home. Afterwards we heard the carers say that we had physio every day because we were being encouraged to walk and do things for ourselves.

At breakfast we were now expected to fetch our own cereals and drinks. I had already shown that I could not hold a plate or cup if I was having to use a walking stick. I was given a trolley to push. The curious thing was that my left arm wanted to pull, not push, so I had to struggle not to go round in circles. Eventually I decided to order toast instead! Someone noticed that it was possible to order bacon as well as eggs from the kitchen. We waited until ten o'clock for it to materialise and a red faced boy came up from the kitchen with a few pieces of well crisped cold bacon saying that it was not normally given to the rehab people but only to fee paying guests.

Like I said, we were poor relations.

What was not accepted was that we were not there free, because the fees were paid for by the NHS. It was just that we were not private patients. Why that should make a difference was a mystery and when I mentioned it to the staff they hotly denied it.

After mulling over the statement that I would have to pay full fees if I stayed longer than six weeks I decided it was time to go home. I realised I was not going to improve much beyond where I was at present, however long I stayed. Much to the well dressed woman's dismay I said I wanted to go home on Good Friday.

"But your stairs are unsafe with the hand rails not fixed properly!"

"I want to go home regardless!" I said emphatically.

"But I explained everything to you in detail. Remember?"

There was so much detail I did not remember any of it. I just wanted to go home! ` As if by magic the carpenter was found to have a slot in his busy week and the hand rail was to be fixed. In the end it had to be sawn off because the plaster was too soft to take the strain and the rock under it too hard for the bit to bite. It left unsightly holes where the screws had been.

"My remit doesn't include filling holes!" he said.

My sweet cottage stairs looked like a botched job done by a schoolboy. I was disgusted by the scuffs in the wallpaper, the bits of blue tape left under the screw holes, and the general feeling that none of it mattered aesthetically. I was having to accept that appearances were not a

priority.

My daughter took most of my things home, tidied up the place and got in some food. Both she and my grandson were delighted I was finally coming home, although there was still a long way to go before I was able to be fully functional. The Charge Nurse brought down a discharge form that I had to sign, taking responsibility for my own wellbeing.

"This is being done against our advice you know. You are not due for discharge until after Easter!"

My daughter had to come to fetch me in her car, and amid lots of sighs of relief I was left in my dear cottage, being cuddled by the welcoming walls and overgrown cottage garden.

SEVENTEEN

"It's not what you know, it's who you know!"

There had been a lot of talk by the staff in the rehab centre about The Red Team who apparently were going to descend on me once I came home. I visualised a group of wonderful, helpful carers who would fuss over me, do a few odd jobs, perhaps prepare a meal, and help me to wash and dress in the morning. Perhaps they would even do a bit of hand washing, or even change my bed sheets. I had demonstrated that I was able to dress myself and give myself a stand up wash at the bathroom basin, but I could not reach my feet easily nor my back. It was soon realised too that I was unable to get into my bath, even with various gadgets. My legs just could not lift up high enough to get over the edge of the bath.

“Good morning! I’ll just quickly fit this security box near your front door. We will put your front door key in it. There is a numbered security code so the Team can get in!”

A large uniformed woman beamed up at me and proceeded to padlock the security box onto the telephone wiring box at street level.

“There now, we’ll just move this flower container in front and then no one can see it! I expect the Red Team will be calling tomorrow, or maybe the next day.”

Satisfied with her good work, she left me to ponder the extraordinary lack of aesthetic value these people had. However I looked forward in anticipation to the arrival of the Team.

After a restless night during which my left leg and arm went into painful contractions I was wakened by someone knocking on my front door. It took forever to get down the cottage stairs, one stair at a time using my left foot first, during which the knocking became more urgent. I have secondary glazing so it was impossible to open a window and tell the person to wait. A rather worried uniformed occupational therapist from the rehab centre stood almost flattened against the front door.

“Its very dangerous here with all this traffic rushing past!” she said, brushing past me into the living room.

“There is a security box with a key in it behind the plant container!”

“Oh is there?”

“Yes, the idea was that you could let yourself in. And by the way, you are allowed to park your car outside the cottage.”

“I would not like to risk it. Now then, I understand you can wash and dress yourself, and make your own meals. What have you had for breakfast? Have you got food for your lunch and evening meals?”

I told her that I had a freezer full of ready meals from the supermarket.

“That’s good then. So I will just wash your legs and feet and change your support socks!”

“I would really appreciate it if you helped me wash my hair.”

The O.T. found a washing up bowl under the sink and filled it with soapy water and proceeded to wash my legs and feet and applied cream to them. I told her that the green support

stockings cramped my toes and seemed to do more harm than good. In fact my feet were quite swollen and my big toe nails had stopped growing.

“You need to see your doctor about that!”

I soon discovered that the Red Team were in fact the same individuals who had attended us in the rehab centre in the care home, and rather than a group, all it consisted of was one individual whose only job was to change my socks. It seemed extraordinary that someone would be paid a good salary just to do that.

I was told to phone the doctor’s surgery to arrange for a blood test and because I was not very mobile, they agreed to send out a District Nurse. Once again she preferred to knock on my front door and parked her car in a layby down the road. There is no footpath on my part of the road and my cottage door is right onto the road. Traffic speeds around the bend and people not used to it become extremely agitated. Of course if they parked outside the door it would be a lot safer instead of walking in the road against the traffic.

“It is so dangerous here isn’t it?”

“Well no, actually! Most of the cars come from people living locally and they know to keep clear of other people!”

She was not convinced. I told her about my green support socks and how they hurt my toes.

She agreed to bring some other type of support hose.

“What colour would you like?”

“Flesh colour would be good!”

A few days later she gave me a pack of three white hose. So I wore a pair of white, and when they needed changing I wore one white and one green. It seemed a weird logic. When the O.T. came to change my socks all hell broke loose. The chief O.T. from the hospital phoned.

“We understand you are no longer wearing our green socks. Why is that?”

I explained how the green socks had hurt my toes and the District Nurse had recommended the change.

“But they are not green. Have you seen any other coloured socks in the hospital?”

“Well yes! There are white ones and flesh colour ones, depending on how long someone has been in hospital!”

After a long silence she said “We can’t justify sending someone out to change your socks if they are not green. You will have to learn to change them yourself.”

Another member of the Red Team arrived two days later and actually used the key to get in.

“We suggest you sit on your toilet seat to wash your legs and feet with a face cloth, and put on your support hose!”. She watched while I struggled to do it.

“Well done!”

I could not see myself doing this exhausting exercise every day. It was expected now that I could easily look after myself.

“We were expecting to be looking after you for another six weeks.” How can changing socks be regarded as looking after?

“I was wondering what other duties you were supposed to do?”

She looked at me warily.

“We observe how well you are coping. If you smell or have food down your front, or the place is dirty and smelling of urine. That is not the case here. You are looking after yourself very well.”

In fact I had to admit I was, but at a great cost.

My daughter worked full time so was only available at the weekend to take me in a wheelchair to the shops. I had a wonderful support group at church who made ready meals and visited regularly. At a pinch I could order food on the internet. My daughter arranged for her cleaner to come in every two weeks to do my housework. It was working out well.

The District Nurse decided not to come any more after I paid a visit to my doctor. I still felt he was to blame for not diagnosing my heart problem sooner. I wanted to show him the condition I was in and hopefully make him feel guilty.

I had an appointment to see the Cardiac Nurse and a hospital car was arranged to pick me up.

It did not arrive so another appointment was made. Unbelievably the car did not arrive for that either. A new appointment some weeks later was arranged. Meanwhile an Adult Services Social Worker called and gave my daughter and me an interview to sort out an application for an Attendance Allowance. It was to take six months dating from the start of my disability before it would be processed.

Another batch of information booklets was sent by the Council as part of the service for disabled people. One of the leaflets was a list of private companies recommended as carers which later on we took advantage of when the family went on holiday. But what I really craved was for someone to give me a massage to relieve the toothache type of pain in my weak arm.

The O.Ts said they were not qualified to help and what I needed was a physiotherapist. I had to tell my doctor.

“Good morning! What can I do for you?” he beamed as I slowly made my way into his surgery.

“I thought I should come to see you since the last time when you told me there was nothing wrong with me!”

He looked glumly at his computer trying to find out what patient he was looking at.

“Yes indeed. And how are you getting along?”

“Okay under the circumstances. I was wondering if there was something you could have done to prevent this from happening. Do you still want to be my doctor?”

“Do you want me to be?”

“I am not sure!”

“Well lets look back to see if anything might have been done differently.” He swivelled the computer so that I could see the screen and we both went through his records and his treatments of the individual presentations.

“But don’t you think you ought to have taken all the symptoms together instead of individually?”

“Well when I asked for an Xray of your chest there was no evidence of anything wrong, and all the tests came back negative. The medication was changed to include a beta blocker and because you tended to have a nose bleed aspirin was ruled out.”

“So how is it that I have been diagnosed with cardiomyopathy? It surely does not happen suddenly.”

“It certainly is mysterious!”

I told him that I needed my arm manipulated and perhaps he could get in touch with a physiotherapist at the hospital. He said he did not really know who to get in touch with because there were so many of them! I was given a phone number to call.

At that time I was finding it very difficult to make sense of information, and the thought of having to arrange appointments and make phone calls was a major undertaking. I seemed to have lost my organisation skills. My daughter explained what was required in letters or questionaires. Actually getting to the doctor’s surgery had been the first time I had ventured out. From now on I was given no help from them because they decided I was fully mobile.

They complained bitterly about having to give blood tests and in the end I was taken to the hospital for regular tests by the kind church support group.

I finally met the Cardiac Nurse who went through all my details and arranged tests to determine what might have caused heart failure. Virus was ruled out and it was thought it might have been hereditary, since my lifestyle had not been responsible. It was just something that had happened. She asked if I was having physiotherapy, and arranged for a lady to phone me. Weeks went by.

I was now feeling more confident to venture out and attended church. The minister gave a huge welcome and the congregation clapped as I went to sit down. A man had been watching me walking and asked if I was having physiotherapy. “What physiotherapy?” I asked wryly.

“Goodness, arent you having anything?”

“I have not seen anyone since coming home!”

“Get in touch with them right away and say that I said you need a brace on your foot.”

Suddenly everyone stood to attention. The man in question was a very well respected brain specialist.

I was given a good series of arm exercises and manipulation, and a good work out for my leg and foot.

After a couple of months I was able to walk fairly steadily but could not lift my arm up higher than waist height. Joining the Stroke Club helped me to realise I had actually progressed quite well, and it was interesting meeting others who were trying to cope with their own disabilities.

I bought an electric scooter that took to pieces to put in the boot of my daughter’s car. We enjoy going shopping together with her striding beside me instead of having to push a wheelchair.

A social worker visited to see what could be done about my not being able to bathe or shower.

She assessed the situation and passed on a recommendation for my bath to be replaced by a shower unit.

A building officer arrived who assessed the situation and made scheduled recommendations for a makeover to fit in with present housing regulations. Some weeks later a council man arrived and made an assessment followed by a contractor who assessed the situation. After several months nothing had transpired and I happened to be sitting next to an ex-mayor and patron of our club. I told him about the lack of movement. He was appalled. “Leave it with me” he said confidently. A few days later I was told the council had given me a grant to have the work done. I am still waiting for the bath to be removed and a shower put in so I can wash with ease.

The ladies from the Womens Institute volunteered to take me to the Stroke Club, and I have a friend who takes me to church and to the social group outings. I had helped to make a community tapestry and out of that a Stitchers group was formed. We are working on special commissions at present and I help with drawing the patterns.

A landscape gardener arrived during a hot period in the year and rearranged my garden to my

design. My grandson helps to keep it tidy for his Saturday job. I am now able to totter around the garden doing pottering jobs without falling over! I hope by next year I will be able to do a lot more myself.

It is eleven months since I had the stroke and heart failure. Moments of frustration come over me when I consider that I will never be the same as before. BUT with a wonderfully supportive family and group of dear friends I am truly blessed.

Its not what you know, its who you know!

Angela Mumford, Dorset, 2008.

HEART FAILURE “Heart failure!” he said “of the severe kind!”

I do not remember exactly when my heart broke.

Perhaps it was long ago When my husband said he no longer loved me As if he ever had.

Or maybe it was earlier still when I glimpsed my native country cliffs Slip slowly out of sight through the porthole Ship bound immigrants to New Zealand.

It may have been when my daughter Young and radiant, left for foreign lands Never to return.

Or when my youngest son made France his home.

Perhaps it was when I bade farewell To my eldest son On a distant shore.

Oceans apart, I silently Grieved for my family to be one again.

Perhaps my heart broke by degrees From separations too hard to bear, Til finally I could no longer sustain A bravery I could not feel.

My children, I cannot do it any more.

This body has declared It has had enough.

I have been strong for everyone else, I cannot be strong for me as well.

So I give in My heart fails And worst of all I have lost my heart.

ARE YOU IN PAIN? Pain? More a twisting sadness Clawing in my gut.

“How do you feel?”

Feeling? What sense there is Has long since melded With the hum of being.

“Can you see with this eye?”

Seeing? Where does this sense begin And another fade?

All is blurred into one great urge.

I cannot do it any longer, Hang between here and there In some sort of tortured knowing Of giving birth to death.

While my body takes control And God regards its fight to stay alive, Deciding slowly when and where to let go.

I watched a lamb once Its body thrashing in an urgent gambol Across some unseen field.

Its body exhausted finally It lay at rest.

What rest?

The farmer threw it on a heap.

There was no Paradise.

MEDICS A gaggle of doctors, straight backed, po-faced, profound Heads in clouds of Latin, Tumbles into the ward, Followed by sycophants, clipboarded, note taking, concentrated.

The problem analysed, assessed.

Attention to detail, by the book, Every symptom taken in account.

Diagnosis not given in real time, Visualised virtually, allowed to progress.

Get it right and everything will be fine, Get it wrong? Well, she was old anyway.

You have to die from something.

And in the end Death is the final healing.

PATIENT NOTES Everything is written down Everything is noted Each minor change Is marked and assessed Each major change Written out in full.

Nothing is ignored Every breath Every heart beat Every temperature Every blood pressure Every drop of water In or out.

Every bowel movement Every movement Every body movement Each meal eaten Or ignored Gas pressure Oxygen intake All is recorded.

The file grows thicker More notes are taken Conversations and responses Human interactions Willingness to fight Overcome, keep on top, Or give up the ghost.

In the end, Its up to you.

A CURIOUS SET OF STANDARDS There is a curious set of standards in this place, Depending on who is in charge.

Though I have been told no one actually takes the lead.

“We are a happy family!”

Well, at least the staff are happy!

As patients, our art is patience.

Not to worry about sitting squashed into a bed pan For half an hour, Or on a commode, bowels emptied Pervading farmyard stinks behind closed curtains.

Last night’s party is discussed By male and female nurses impervious to patient dignity.

Nothing shocks them, they’ve seen it all before But what about us?

Exposing private parts to strangers is an every day occurrence.

We have patient rights to agree or disagree With treatment, whether to eat or take medication, But no right to complain that Our bums ache from sitting in uncomfortable beds Or the kind offer of a cup of tea does not materialise.

Cleaners diligently wash floors and wipe tables Coughing and sneezing over the food While a man in isolated infection Wanders aimlessly touching this and that Around the ward.

THE ISOLATED MAN Gene Wilder I cast in this man’s role A rakish look about him Hair wild and woolly, madness in his gaze But logic argument at every test of wit To keep his infection isolated.

Balking restriction, running naked, free Urinating as he flees like a trapped animal.

Sparking intruder alarms, With nurses chasing the chaos he leaves in his wake.

No treatment contains this raddled, clotted brain, Pleas and protests do not reveal The torment of his soul.

OPERA ARJO

Elegant, strong, reliable robot, Arms outstretched to hold fast the crumpled bundle.

Body swing, posterior exposed ready to be wiped.

A baby, vulnerable, held, cradled All dignity bereft.

Spray and wipe, lowered gently.

Opera, silent running, guided by the handler Speaks volumes in strength To the weakness of the broken In his care.

There is no face of recognition No artificial lights To communicate messages of goodwill.

How easy to spill the cargo, rampage In dervish dance around the room.

But Opera stands tall, reliable, strong Upholding equilibrium in stately silence A symbol of a caring system Reliant state of art.

ENCORE ARJO Encore! again and again!

Sturdy, squat, safe Encore, Opera’s sister takes the strain.

Fat supine patients lifted to their feet From bed to chair and back.

Encore I say, and again Encore!

Robotic arms reach out And gently place, recline again.

Equilibrium restored To snore once more in thankful oblivion.

OVERTURE AIRBED Squashy and comfortable Overture rolls and waves, exotic.

Alarmed, losing power she trills and bleeps.

At first a sound Quietly reminding her breath is slowly leaching out.

Then more strident in a higher tone Ignored by nurses tending patient needs.

The bed slowly engulfs its charge Like some monster from the depths.

Wailing madly, madly wailing, Driving everyone insane Til at last someone throws the switch And crackling like a log fire Overture again begins to bring Comfort, solace, squashy movement To crumpled humanity.

BLUE MONDAY

They sit or lie, mouths open, eyes shut, White, moppen haired, limpen, lumpen women Stricken stroked, never moving.

Did they ever get beyond couch potato anyway?

Some helpless, hopeless, Waiting to be fed by hand Or put to sleep, put down, maybe painlessly!

Where is the joy in this blue Monday?

Struggling with a sudden lack of motivation To regain lost limbs, thoughts, speech, These lives lived in gainful action Hope taken in a sudden brainstorm.

Fluffy haired, sleeping, snoring moaning, Groan filled wakefulness.

Floppy bodies, floppy heads in untidy rows.

Curtains hanging as loosely.

What kind of therapy is this?

WARD ROUTINE

Antlike, on unseen quests, nurse aides and staff Wander in and out Changing beds, rolling patients on their sides, Fetching bedpans and commodes, Dispensing drugs, answering questions Putting off requests for help In case their actions create a change From a chaotic pattern Set down in stone eons ago When Nightingale ruled supreme.

Catheter bags of urine Hang like mournful washing Beside the beds.

Sad reminders That escape is not imminent.

Those not unconscious Soon will be, Beaten into a submissive state, Staring into middle distance.

SAG OF TIME Like waiting in an airport transit lounge This aimlessly dull, staring eyed, head dropping Sag of time Not noticing who is behind or in front.

Who cares anyway?

Can I pinch you for a couple of minutes?

Disembodied observation unit trundles, Squeaking, puffed up, Systolic deviance now controlled Panicky out of breath Rhythm back to life.

This wait continues Impatient patience Intemperate, slow Waiting aimlessly in the airport transit lounge For a door to open.

Thermometer, breathing, water measures, normal.

Walk this way.

If only!

I can and will walk again.

VISITORS Kindly people visit in clusters To suck the little energy remaining in the room.

Staring disbelieving at tongues protruding From twisted faces blotched on pillows.

Panting, wobble heads struggle To respond to inane questions Impossible to answer.

Normal conversations Stilted With embarrassed laughs.

They stay too long, Talk among themselves “How sad to see her so!

She who was so strong!”

“Can happen so quick!”

“Any time!”

They leave bewildered, Solidly believing, hoping It will never be their fate.

THE WAITING GAME Some people, mostly women Lie among the puffed up pillows Hands fluttering like baby sparrows Waiting to be fed.

Helpless, without vitality They wait for succour Not willing to help themselves.

They call out, frail and weak Bring me this and that.

Unable to overcome A deadly lethargy.

A new patient arrives Beautiful and petulant, Unable to speak.

Frustrated and angry She refuses to engage Lowers her eyelids Resenting the visitors.

Trying to hide.

Wishing only to be left Alone in her misery.

Her husband Ever cheerful

Tries desperately to rally her.

Waiting for her To lovingly react To his ministrations.

Ignoring him She sees his misery Through his jolly smile.

Enjoys the angst Hoping to involve him In her anger.

Everyone plays their role In the waiting game.

THE DIVA She was beautiful once, Pampered, adored.

Now lying cosy In amongst a cloud of pillows Refusing medical attention.

A Diva, loved, and powerful Her only weapon Used to spite herself, The right to deny help.

A flower in full bloom, With joy in the beholding Turned wizened, cantankerous, Argumentative She wills herself A lonely death.

Patience exhausted, left alone To weakly flap against sustenance.

Her daughter, plain, well meaning Takes on the burden from the State At home, she will once more Reign supreme.

Dictating from her pillows And secretly walk Around her bed at night Muttering against her fate.

PATIENTS IN THE STROKE RESPONSE UNIT White halo of hair, Sparkling eyes smiling In a contorted resemblance Of who she once had been.

Feeding through her nose Life giving sustenance.

No feeling in her body Once vital.

A party person, full of energy, Bell ringer and hill climber, She lies now mute, struck down.

Her eyes alone betray a hope She once again can laugh out loud, Speak her daughters’ names And even recognise their faces.

Opposite her bed Bleating like a sheep Calling for her lamb Calling for a nurse To put her body in some semblance of shape She once called her own.

An arm festooned with tubes and canular Like some automaton Connected to Mother Ship She barks orders, rasps, denies food Angry at her state.

Further down, A pretty cuddled, cuddly woman Pink and Blue Surrounded by loving friends And family adoration.

Bemused by sudden affliction Stricken stroke Right side numbed.

Head befuddled, forgetful, coughing Oxygen masked, drug sustained She tries to keep awake But worn down by endless mind numbing inactivity She drifts into oblivion.

CHURCH LADY Prim, polite and politically correct A plump church lady, reading her devotions, Displays a remarkable facility For expelling wind In tuneful explosions Accompanied by an apparent Lack of ability to clear her throat Without loud snorts and gravelled breath, Dispensing sputum in a cardboard bowl At intervals in the night.

Patient, godly, she sits in repose Puzzling crosswords Puzzling how She came to be Among the presently disabled.

Once so active, community conscious.

Friends and neighbours visit Criticise each other Presided by their defunct president.

Bedside committee dissolved.

MALE AGONY Male heads at crazy angles Peer over sheets like frantic birds Alarmed by sudden captivity.

Arms, slow, weak, trembling, Flailing in vain effort To grab hold of anything That gives reassurance.

Some, with beaklike noses pointing to the sky Above gaping mouths, snore and snort At feeding tubes While legs assume humping shapes, Kicking and squirming.

Angry shouts, demanding With loud animal roars, constantly complaining.

There is no peace Nor stoicism in the male ward.

SOJOURN IN THE MALE WARD “I vant to die“, he said This man once big and strong From the Steppes of Russia “I am paralysed. No one wants me!”

He cries like a mythering baby Whining to be picked up and carried.

Waving his arms above his head, He demands to have his needs met.

Further down the ward A patient Canadian makes noises Like a roaring lion.

His breathing is a set of gasps As if he is laughing, Reinforced by his wide grimace, Nurses think him a joke Encourage him to laugh even more When in truth he really wants to cry.

Little old, old, wrinkled man Writhes and wriggles like Golan Wangles his way between the bed rails Falls like dust on the floor.

Lifted up again, he does not stay still.

They build a cage around him on the floor.

He would be better off in a bag.

CHAOS REINFORCED The man in the bed opposite Cannot make sense of it.

He examines in great detail The wires and tubes Attached to his wrist.

It is a mystery to him How these came to dangle Like alien tentacles From his arm.

He spends every waking moment Trying to take them apart Unravel the bandages That hold them secure.

He discovers other tubes Attached to his head Pulls at the one that feeds into his nose.

Strident alarm signals a twist But undeterred he drags at the wire,

Nurses run, too late.

Attached once more to feeding tubes Drips and catheters He continues his quest To make some sense Of his chaotic state to reinforce He is not in Hell.

TIME TO MOVE ON I saw you when you first arrived, Tall, strong willed, incredible.

You sat up straight from lying down Like some strange ghoul from Friday the 13th.

Covered in dark bruises You looked as if you had been beaten up By some feverish hand.

“She fell down stairs” they said The usual excuse.

You spoke in loud unintelligible sounds Impatient with your impotent words.

Sudden brain attack some time in the night Your body took over to stay alive.

Heaving and thrashing, fighting to gain control.

But after a while You gratefully gave in.

This morning a new patient lies in your bed As if you had never been.

We did not mourn your going.

What else can be expected?

We live too long anyway And someone else Will always fill the space.

THE NEW PATIENT Stroke victims are hardly ever young.

No surprise then, the new patient Is an elderly woman, square, full faced, Quiet and placid in appearance But that may change.

The new arrival Looked on with suspicion Like a strange cub wandering Into a pack of wolves.

We do not sniff in her direction

Nor engage in conversation.

Perhaps its better to remain aloof.

Engaged in our own bubble lives Not wanting to disturb the equilibrium Surrounding our own space.

We reason she is probably incapable of understanding Or making sense of sight or sound.

No doubt the night will reveal peptic truths Shared by us all, With bedpans, snores and passing wind.

No dignity left When male nurses Wipe between the crack And Opera reveals the truth Beneath the shroud.

BLOBBY WOMAN Blobby woman, owl eyed but cannot see Nor hear, except selectively, Complains and rails Against State Social Services That will not allow her To return home without assessment.

An invasion, according to her, Of her privacy.

Confident of her own abilities She squats like a toad Waiting for a passing fly, Instead of proving her strength By walking around the ward, Or gaze at passing traffic from the window.

Even play scrabble in the Day Room.

Lazy, blobby woman Complaining blobby woman.

Expert at emotional blackmail, Accuses her loving family And visiting grandchild to tears.

Says she is not wanted, left, abandoned, punished Away from home where Eventually she will founder And return more broken than before.

When patience and a willingness to move about Might give her hope.

MAIDEN CASTLE REHAB CENTRE INMATES I hobble down the corridor Like a marionette from Thunderbirds Left arm drawn up, balance uncertain Left hand clenched in unwilling embrace To greet the patients sitting at my table Waiting for dinner to be served.

The carer bustles from one to the other Like the White Rabbit in Alice in Wonderland Running to keep up with her work load.

With clatter of cups and glasses of orange juice She takes our orders, doles out mashed potato Unidentifiable stew and soggy carrots.

A bulbous body in an oversize wheelchair Sails like a massive galleon And deftly manoeuvres her chair Up to the table.

She laughs out loud in spite of her affliction And chatters in Dorset dialect, inclusive, loving.

Opposite, a man, deaf as a post Large and cuddly grandfather, jokes And plays the fool.

His deaf aid whistles with every move Leaning forward to make out what we say.

I help him spread the butter on his roll.

Bubble hair cut, permed old ladies, Grumble and bewail inabilities Lifting heavy knives and forks to open mouths.

Scratching plates, cutting morsels into dainty slices, Food pushed around the plate into mush Messed and finally swallowed.

Most spilled into laps or stuck to chins They gnash loose fitting dentures But hardly taste what is eaten.

I am accused of eating too fast, Not masticating my food, swallowing whole.

I use my fork like a spade and have all my own teeth.

It is a ritual learned in childhood Lady-like balancing of cutlery Precision of poised fork with knife Delicate, not appearing to eat large mouthfuls In fear of perceived greed.

Wasteful, finicky, mannered image of gentility Now no longer fits disabled age.

UNCERTAIN CERTAINTY

Arms entwined, bony fingers clutching her chin, She anxiously surveys the breakfast table With unseeing eyes, blindly Unable to distinguish shapes and colours More than inches from her wizened face.

Medication stacked beside her among the cups Non comprehending she sifts each box Checking and double checking the order And number of tablets to take In compulsive need for attention to detail.

Muttering, sorting, losing track Breakfast forgotten in a feverish attempt To keep order, help denied Lest she forget the regularity of her pills.

The one last link that keeps her alive.

****************

I wrote these poems whilst recovering in the Acute Stroke Unit and in the rehabilitation centre at Maiden Castle Care Home, Dorchester, Dorset between December 2007 and March 2008. Although I regarded my own situation as a comedy, like all comedy there is also a sense of tragedy, especially when put into perspective with what is happening around about. These writings express the peculiar situation I found myself in, and the seemingly grotesque Heronymus Bosche depiction of the effects of stroke on elderly patients. I would like to say that almost everyone recovered enough to return to normal life, but many remained permanently disabled.

Angela Mumford, Dorset 2008.