Harborview Medical Center, Julie Lary, physical therapy, Providence Mount St. Vincent, Rajalary, Richard Lary, scribbles writing, TJ
Continuation of Unpredictability of Life
The day after Rich’s aneurism surgery, I was scheduled to be transferred to Providence Mount St. Vincent’s transitional care unit for in-patient physical therapy. Because numerous people needed to approve my discharge from Harborview, including physicians, nurses, and physical therapists, I knew that I wouldn’t be leaving before noon.
Early in the morning, a member of the Harborview plastic surgery team visited. I was dumbfounded by her need to examine and “sign-off” on my leg. Until that point, I’d been basking in denial, and with my lower leg always wrapped in gauze and ace bandages, I’d forgotten the back of my calf had been ripped open when I smashed into the ground after our motorcycle was struck.
Unbeknownst to me, my leg tissue could have become necrotic from the gash on the back of the calf or the puncture wound on the front when my fractured tibia poked through the skin. In addition, my tissue could have died following surgery because of the lack of blood flow. Fortunately, the heavy-duty antibiotics they’d intravenously pumped into my body for a few days did the trick and there were no signs of necrotic tissue.
Later in the morning, a physical therapist visited to measure the distance I could walk with a walker, ability to do daily activities like go to the bathroom and dress myself, and whether I could climb up and down a small set of stairs, using a crutch. It’s more scary than difficult, especially since you practice on a short set of stairs with rails on both sides.
Once I was told a cabulance – van that can accommodate a wheelchair – would take me to Providence around 2:00 p.m., I packed up my stuff, and changed into street clothes, a pair of work-out pants and yoga tank top. Days earlier, Stacey and Chris had driven to Coupeville to retrieve items from our house including Rich’s eyeglasses, backpack, tablet, and a couple of shirts, and my PC, tablet, workout clothing, and pajamas that I could wear in rehab.
I was grateful Stacey brought a wide assortment of clothing, so I wouldn’t have to wear the same outfit over-and-over again. While I wear the same clothes all week when I work from home, it was nice to have an assortment of clothes, so every other day felt a little special.
Ironically, the pajamas Stacey packed, Rich had purchased 12 years earlier when I was at HealthSouth in Austin, TX after fracturing my pelvis in four places and cracking several ribs. At the time, someone said you’re usually only in one major accident in your life. Obviously, I’m the exception.
While I was excited to be moving forward in my recovery, I realized I wouldn’t be able to see Rich for a couple of weeks while he recovered from brain surgery, and then went to a rehabilitation facility. Chris and Stacey had been meeting with a social worker at Harborview to get Rich transferred to the Swedish Cherry Hill Acute Rehabilitation Unit rather than Providence. The former would provide him with at least three hours a day of intensive physical, occupational, and cognitive therapy.
I was torn, wanting to be with Rich, but eager to start rehabilitation so I could come home. And the sooner, I could go home, the faster I could return to work, something I desperately needed to do to restore my mental and emotional health and boost my sense-of-worth. Working would be a welcome distraction from the accident. And even though my supportive employer Bridge Partners Consulting made it crystal clear I wouldn’t be losing my job, I wanted to stay at the top of the pack and choose the projects I worked on rather than relegated projects rejected by other consultants.
I was also anxious to leave Harborview because where Rich’s bed had been on Monday morning was empty for most of the day. Late in the evening, another patient’s bed filled the space, and a curtain was drawn between us. The reality Rich wasn’t coming back to the room was upsetting. He was in the neurology intensive care unit, zonked-out on sedatives, and another building away.
Tuesday morning, I’d wrestled up the mettle to learn about my roommate. She was an elderly woman who’d been flown by Airlift Northwest from Juneau, Alaska after falling and fracturing her hip. Her daughter, who lived near Seattle, was a congenial woman, explaining that despite Juneau being north of Seattle, the weather is similar with the Pacific Ocean tempering its weather. She commented sometimes it’s colder in Seattle than Juneau.
I enjoyed talking to her, and learning about her mother who was a strong, determined woman, who’d lived a life full of adventure. Everyone I’ve met from Alaska is similar, good-natured and tenacious with a zest for life.
With my bags packed, and cleared to transfer to Providence, there was nothing left to do, but wait. Happily, Stacey snagged a Michael Graves transport chair, which are super comfortable and made me happy. The design is brilliant with marine blue seats and armrests, yellow and dove gray accents, and footrests that automatically swing up. The only drawback is you can’t wheel it yourself, which curtails patients like myself from grabbing a chair, and escaping down the hallway.
Once in the chair, she and Chris headed to the garden area in front of the hospital. It was the first time I’d been outside in over a week. While I’d visited Seattle uncountable times, having driven up from Portland, lived on the east side, and visited Microsoft’s office in South Lake Union, I’d never internalized the location of Harborview, towering a few blocks above the freeway.
It was nice to be outside, especially with the fabulous view of downtown Seattle. A hovering Airlift Northwest helicopter shattered the tranquility and brought back memories of having landed on the same heliport eight days earlier.
When we moved to Whidbey Island, someone suggested we purchase an Airlift Northwest membership because of the limited medical facilities on the island. It’s incomprehensible that we needed to use the service and the destination was a life-saving level 1 trauma center.
While it was nice to be outside, I was anxious to see Rich. I reasoned he was doing better from the night before and would be happy to see me. I kept pressuring Stacey (and Chris) to wheel me to the neurology ICU. She quelled my enthusiasm, saying he was resting. Around 1:30 p.m., she relented, wheeling me to his room, a large open circular space with several patients, separated by curtains.
Rich’s stump wasn’t bandaged and was sticking straight up in the air. He was tethered to the bed with “gloves” on his hands to prevent him from grabbing at tubes and pulling them out. Even tied down, he was thrashing around, trying to get free, while muttering gibberish. Stacey quickly spun me around so I wouldn’t see Rich’s exposed stump. But it was too late. I couldn’t un-see what I’d seen.
When she turned me back around, she’d covered his stump, but she couldn’t conceal Rich’s agitation and complete disconnect from reality. While he recognized Stacey’s and Chris’ voices when they called out to him, berating them for something seconds earlier he’d fabricated in his tormented mind, he had no recognition of me, even when he opened his eyes.
It was heartbreaking. My husband, lover, best friend was gone.
I asked to be wheeled close to the bed so I could stand up and give him a kiss, then pleaded with Stacey to take me back to my room to await the cabulance. It was hard to hide my devastation. As we passed by the nurse’s station, a nurse, a smile on her face, rushed out to ask about my visit with Rich.
I couldn’t conceal my tears and anguish.
Solace to heal
The cabulance arrived as expected. I put up a brave front, anxious to leave Harborview, and the outward hopelessness of Rich’s condition. We’d been told that he’d be disoriented for a few days after the surgery, but I never expected him to become completely lost in hallucinations with no grasp of reality.
Providence is just 6 miles from Harborview, so I expected to be there in 15 minutes or so, but it took nearly an hour with bumper-to-bumper traffic. Fortunately, the driver was sociable and willing to answer my endless inane questions. I chatted non-stop for the entire trip, partially out of nervousness and partially because of my distress over Rich.
More than 400 adults live at Providence, a five-story building with a mix of assisted living apartments, skilled nursing neighborhoods, elder day care programs, and short-term rehabilitation units. It also houses an intergenerational learning center.
Just past the lobby and on the third floor, are rooms filled with children 6 weeks to 5 years old, who participate in traditional day care activities, such as music, dancing, art, and storytelling, along with interact with residents and patients. It’s a wonderful experience both for the children and the residents.
Also, on the first floor is a large gift shop, barber and beauty salon, thrift shop, sewing and alterations shop where residents and volunteers busily mend residents’ clothes and make items to sell, and computer and TV area. Lining the hallways is art from local artist, some of which is for sale. A tall curio cabinet in the lobby had Huichol yarn painting, which was breathtaking.
After taking the elevator up to the fifth floor, I was wheeled to the far end of a “neighborhood.” I was expecting it to be bright and cheerful, but it was dark and gloomy, except by the nurses’ station. I immediately regretted the decision to go to a rehabilitation facility, especially after being wheeled into the room, which had two twin beds, each with a nightstand, a small sink area, and a door, which I assumed lead to a small bathroom. My initial thought was it was going to be challenging to move around the room with a walker, let alone a wheelchair.
With my fate cast, I took a deep breath, and was somewhat relieved after meeting my roommate, sitting at the foot of her bed. She was a Jewish woman with a gravelly, but comforting voice. I immediately started crying, no longer brave and in control of my emotions. I shared sparse details about my situation. She laughed, saying God has a cruel sense-of-humor, elaborating on her medical issues, which landed her in the hospital, and then Providence until her health stabilized.
We talked for maybe 10 minutes before an administrator came to see me, starting the conversation by saying my room was still being cleaned, and I’d be brought there when it was ready. She then asked me a series of questions from a survey and had me sign a stack of papers.
Despite my initial impressions of Providence, I was feeling more confident after chatting with her. Once they rounded up a wheelchair for me, I wiggled my butt from the bed to the chair and was excited with the opportunity (and freedom) to wheel myself around. However, I had zero energy. After wheeling myself down a short hallway, I was out-of-breath.
Seeing me struggle, the administrator offered to take me on a tour of the facility, showing me the cafeteria on the second floor where I could get my own meals or have meals brought to my room. She also wheeled me by several sitting areas and onto the patio, a pleasant space with raised beds of flowers and herbs. If I needed a place to reflect, she recommended I visit the chapel on the third floor.
With the tour over, we took the elevator to the fifth floor, this time passing the “neighborhoods,” up a short-graded hallway to a space that may have connected two buildings. This area was much newer. The brightly lit hallway had four or five rooms on each side, and at the end a large area for physical, occupational, and massage therapy. Across from the therapy room was a small dinette with drinks and snacks, and a large screen TV.
My room was a complete surprise!
It faced west with an extraordinary view of Elliott Bay, Harbor Island, downtown Seattle, and part of West Seattle. Harbor Island is a 350-acre artificial island located where the Duwamish River empties into Elliott Bay and is primarily used for commercial and industrial activities, including containerized cargo shipping. From my window I could see boats of all sizes from graceful sailboats to sleek ferries, and lumbering cargo and tanker ships and barges. It was truly magical, especially at night when the city sparkled.
Once I got to my room, a wave of exhaustion hit me. An on-staff physician came to take my vitals and learn more about my condition. I mentioned how I struggled to use the wheelchair, attributing it to the emotional upheaval of seeing Rich and increased physical activity from taking the cabulance to exploring the facility, unpacking my bag, and putting my clothes in drawers and toiletries in the bathroom – something that would be easy with two working legs, but challenging in a wheelchair with one leg elevated and painful to move.
Towards the evening, Stacey and Chris visited briefly. I was glad when they left because I was emotionally and physically spent. Even though I said I would go to the cafeteria for dinner, I was relieved when the staff brought me baked salmon with plenty of tartar sauce and several side dishes.
After eating, I changed into pajamas and climbed into bed. Because my room didn’t have air conditioning, I opened the window and turned on the fan. It was soothing lying in bed, listening to the ambient sounds from the city below with the cool air blowing over me.
Around 9:00 p.m., I started feeling uncomfortable. I called the nurse, asking whether I could have some pain medication since I hadn’t taken anything since, I’d left Harborview seven hours earlier. She said no medications were scheduled for me, which seemed odd.
She returned a few minutes later with Tylenol and Oxycodone, explaining the instructions for my care had incorrectly been typed into their computer. They’d entered 8 a.m. twice instead of 8 p.m. It wasn’t the first time they botched my medications. Thankfully, I didn’t need anything that regulated anything vital like my blood pressure or arrhythmia!
Counting off the days
My first full day in rehab featured a parade of caregivers. A speech therapist spent an hour administering tests to determine whether I had any cognitive loss. For one of the tests, I was asked to name as many animals as I could in two minutes. Another was a jumbled picture in which I was supposed to identify all the objects. I passed with flying colors despite having difficulties with the last test, which had reversed images.
A social worker then visited, getting the scoop on my mental state and expectations. I immediately planted the idea of my leaving after a week, even though I was cleared to stay up to two weeks. I didn’t want to stay any longer than necessary, and more importantly, wanted to go home and return to work.
Next, the physician dropped by to see if I was doing any better. Sadly, I was still fatigued. The next morning, a phlebotomist, a cheerful woman from Russia who resembled a matryoshka doll came into my room at 6 a.m. to get a blood sample. A few hours later, I learned I was still severely anemic, which accounted for my weariness and rapid heartbeat.
Late in the afternoon of my first day, I had physical therapy with a slender woman named Anna. While everyone had been comforting and empathetic to my condition, Anna was harsh and seemingly bothered by having to provide care. She wanted to benchmark my current state.
Initially, she had me do a few things on the bed, such as bend my knee and rotate my ankle. I was then instructed to use a walker to walk as far as I could in two minutes. I thought I did pretty good, going down the entire hallway, and then turning around and going partially back. She wasn’t impressed, saying I’d done poorly for a “woman of my age,” disingenuously adding, hopping on one leg probably impacted my speed.
You think? It’s not like I had been thrown off a motorcycle at 45 miles per hour, 9 days earlier, breaking my femur, tibia, and fibula in six places, getting stitches from my ankle to the top of my hip, and having an erector set of metal in my leg!
Next, she measured out a distance on the floor, and timed me to see how fast I could walk – using a walker — down the line and back. She had me repeat this exercise twice.
I then questioned her approach to physical therapy, saying I’d been instructed by the physical therapist at Harborview to do stretching exercises on a bed or massage table to stimulate and increase the flexibility of the muscles in my left leg. Walking as fast and as far as I could with a walker wasn’t a recommended exercise to counteract my leg muscles from atrophying.
I was thrilled when I returned to my room and could have a good cry. Weeping and lamenting defined my stay at Harborview and Providence.
Happily, as the sun started inching down, Cleo Molina, a stunning woman with a halo of silver curls asked if she could come into my room. A chaplain, she spent over an hour talking to me while I cried, ranted and raged. We discussed the need for people to take responsibility for their actions and justice being a cardinal virtue of Catholicism, along with prudence temperance, and fortitude.
Her talk was exactly what I needed to begin purging myself of the horror of the accident and the crushing disappointment of not being able to immediately return home, put on a pair of grungy pants, work in my garden, cook a meal, put out birdseed and hang up hummingbird feeders, clean the house, take a walk on the beach, or even easily take a shower.
I was numb from the unacceptable reality that Rich’s leg was amputated, and he’d become delusional and incoherent from brain surgery. Everything that maintained my sanity was gone. My lifelines had been severed. Rich my mainsail was unreachable. I was merely flapping in the wind, moments from falling overboard.
The few positives in my coming days was the amazing view from my room, the friendly staff at Providence, TJ the polydactyl cat who ruled the therapy room and prowled the hallways, and the unexpectedly good food in the cafeteria.
Three times a day, I took the elevator down to the second floor to the cafeteria. My first morning, I asked for fresh fruit and was handed a plate of raspberries, blueberries, pineapple, grapes, honeydew, and cantaloupe. I almost started crying when I saw it. I relished every bite in-between nibbling on a hard-boiled egg, and drinking fresh orange juice, coffee, and milk. Everyday, I had the same breakfast, except one morning, I spied a plate with two eggs over-easy, which I had with whole wheat toast. Yum!
My lunch usually consisted of a plate of spinach, tomatoes, bell peppers, garbanzo beans, and other vegetables with blue cheese dressing, soup or yogurt, and sugar-free lemonade. Dinner was similar except the dietician told me I should order a piece of salmon or chicken to boost my intake of protein.
Every day, I looked forward to meals with the wide selection of fresh fruits and vegetables, eggs, yogurt, and salmon with lemon or tartar sauce! Plus, it was good for my physical and mental health visit the cafeteria and be among other people.
Getting in the groove
My first full day at Providence was exhausting. After dinner, emotionally drained, I decided to visit the “alleged” chapel on the third floor. I was stunned, thinking it would be a small room, off to the side with a couple of pews.
Instead, it was akin to a full-sized church, with tall ornate windows, decorated ceiling with art deco lights, elegant altar with a gold and red backdrop, and seating for several hundred people on three sides and in two balconies. The light streaming through the windows and soothing eggshell-colored walls was unexpectedly restorative.
A hidden treasure, built in 1924, the chapel was part of a retirement home for Sisters of Providence and other religious women. Another building, which is adjacent to Providence now houses retired sisters. Every morning, a short broadcast could be heard in the hallways in which a sister would say a prayer.
Nearly every day, there are Catholic services in the chapel, as well as Protestant worship on Sundays. Additionally, the chapel is used for weddings and other events. I visited the chapel many times during my stay, including attending a performance of a children’s chorus.
While I barely spoke to anyone for the first few days at Providence, I realized I should do more than wallow in my misery. I’d spotted Jeff the first time I visited the cafeteria. A double amputee, Jeff was gregarious, optimistic, and entertaining. His past explained his personality and ability to look past obstacles and see opportunities.
Originally from Texas, which explained his energetic personality, Jeff had overseen a Catholic Charities homeless shelter. While jogging several years ago, a cut on his right foot became infected. A flesh-eating bacterium resulted in the leg having to be amputated below the knee. This injury instigated diabetes, and his other leg was subsequently amputated.
Despite these hardships, Jeff was always upbeat, and willing to patiently answer my endless questions about the process of getting a prosthesis, challenges of using one, and what could go wrong. The day before I left Providence, Jeff had an ear-to-ear grin. He was leaving to move into an ADA apartment and return to his life of overseeing a homeless shelter. Wow!!
Another person with a larger-than-life personality was a middle-aged heavy-set woman from Juneau. She’d broken her leg two months earlier, and like me, was non-weight bearing. Because her house in Alaska was two stories with the first level above the garage, she had to stay in Seattle until she could walk. She was several weeks away from starting to stand on her broken leg, and while anxious to go home, she’d made the best of her time, reading, enjoying the sunshine, and making friends.
One evening, an older distinguished man with a baseball hat sat across from me. He’d been a union representative for many years and spoke fondly of his days at Boeing. He was always surrounded by women probably because he was well-mannered, had a soothing voice, and told great stories.
After chatting with me for a few minutes, he was joined by Jean, a firecracker of a woman who immediately launched into her life story, relaying how her name was just four letters in length because according to her father, “We’re Scottish and don’t waste letters.”
Unprompted, she proudly exclaimed she had the perfect family, two girls and two boys. Her husband and her saved for five years to spend fifteen months traveling with their children to dozens of countries. In Ireland, they rented a gypsy wagon and spend a couple of weeks enjoying the countryside. While in Turkey, her blue-eyed daughter, wore sunglasses whenever outside because traditionally blue eyes are considered evil. Throughout Turkey, dark blue ceramic eyes, Nazar Boncuğu, are worn and hung in houses as protective talisman.
Jean’s husband, Bill, was with the National Park Service for 27 years, working in Yosemite, Death Valley and Mount Rainier. After he retired, they joined the Peace Corp, volunteering in Colombia, New Guinea, Egypt, and China. Jean said that when they were in their 60’s, they climbed a peak in Columbia, which was named after them.
Still active in her 80’s, Jean said after studying a majestic tree, and determining the best route up, she climbed to a high branch. She smiled, recalling people looking up at her and exclaiming “There’s a grandma in a tree.”
For many years, a book she wrote called “Let’s Go Camping: In a National Park” was sold in national park gift shops.
When I asked about her children, she sighed, saying one of her sons died in his early fifties. “I’m 95 and I couldn’t give him any years.”
While at Providence, I wrote a blog post titled, “Observations from the Cafeteria” about a woman with a severe spinal deformity who’d routinely got food from the cafeteria. Instead of staying there to eat, she’d wander over to women she knew, exchanging pleasantries. Often giving them a hug or caressing their heads before leaving. I was enthralled with her gentle manner and lovely smile.
One day, she was in front of me in the cafeteria line. I was determined to speak with her before she left. Her name was Patricia and the few minutes I spoke with her brighten my day.
The saddest story I encountered was of a man who’d been a supervisor at a large commercial bakery in Seattle. He’d worked his way up to management after years of being a driver, and then a baker. During a routine CT scan, he’d fallen fracturing his spine. After a year of being hospitalized and at Providence, his medical benefits were running out in July.
During one of my physical therapy sessions, I saw him stand up with the help of several people. It was the first time he’d stood up in a year. During that time, his wife lost her job as an accountant, and it sounded like they were down to their last penny.
Moving towards independence
The second day of my physical therapy, after I learned I was anemic and was visited by a dietician who lectured me on eating more protein, I once again met with Anna, stating my hopping with a walker up and down the hallway was doing nothing to stretch out the rapidly atrophying muscles in my left leg. Instead it was taxing my oxygen-starved muscles. I pulled out my paperwork from Harborview, showing her the exercises I’d been told to do.
Anna reluctantly said we could do exercises in the therapy area. First, however, I needed to use a crutch to go up-and-down a short staircase with rails on both sides. While scary to do, it wasn’t difficult, and I knew it was a competency I had to demonstrate before they’d release me to go home.
We then proceeded to do exercises on a large therapy table. Instead of doing gentle exercises like flexing my ankle and bending my knee, Anna thought it necessary to yank on my leg, and have me do leg lifts, clamshells, hip abductors, and bridges. None of these exercises were prescribed at Harborview, but I kept thinking, “Anna must know what she’s doing.”
For days afterwards, I was in horrific pain where my leg met my hip. A month later, my orthopedic surgeon at Harborview, noticed a previously undetected hairline fracture on the neck of my femur was now a non-displaced fracture, which resulted in my having emergency surgery in late July.
Happily, for the rest of my time at Providence, I didn’t have Anna as my physical therapist. My last day of physical therapy, the therapist told me to do very lightweight exercises since my leg had been through extensive trauma and contained an erector set of metal. Duh!
To ease the tedium at Providence, since I barely had an hour of physical and occupational therapy a day, I had several visitors.
Three days after I arrived, Pam and Andrea, who’d been taking care of our house and pets in Coupeville visited, bringing me a huge salad that contained the produce from our garden. I thoroughly enjoyed visiting with them and afterwards relished eating spinach, kale, radishes, and green onions from our garden, along with store-bought grape tomatoes. Shannon, who was also taking care of our house, and worked with Rich at Island Transit, had prepared the salad.
On Saturday, Shana, who I’ve known for several years after meeting her at Temple B’nai Torah, brought me a beautiful bouquet of red and peach roses. We talked for a few hours, which was gratifying, especially getting her spiritual perspective on Rich’s and my bad karma. Although, she felt it was good karma since they discovered Rich’s aneurysm, which could have burst at any time, instantly killing him.
Sarah, a friend from Microsoft, arrived on Sunday afternoon, bearing gifts: A gorgeous bouquet of blue, pink, and white flowers, including large stargazer lilies from a local farmers market and a bag of treats: Goldfish, pistachios, gummy fruits, animal crackers, and Sour Patch Kids. I was happy to see her, having been antsy and bored all day. Weekends are the worse at medical facilities because they usually have a skeletal staff and no activities to pass the time.
When I wasn’t going to the cafeteria, doing physical or occupational therapy, or writing on my PC, I spent my days “hunting down” and “pestering” TJ, the arrogant, but magnificent polydactyl ginger cat. Brought to Providence when a kitten, TJ wasn’t leery of wheelchairs, walkers, canes or residents eager to interact with his royal cattiness.
He spent his days sunbathing, stretched out on the stairs in the therapy room, sauntering down the hallway, and wandering into patients’ rooms. My first evening at Providence, he came into my room, sprawled under the extra bed, extended one of his middle toes, and telepathically relayed, “You can’t get me.”
On my last night, unbeknownst to me, he was in my room for several hours. I’d closed the door and was writing on my PC. When I got ready for bed, he showed up, ambling over to the door to be let out.
When bored, I’d track down TJ for one-sided conversations. A couple times, he was stretched out in the middle of the hallway because it’s everyone’s responsibility to walk or wheel around him. He allowed me to reach down and scoop up his 15 pounds of warm, fluffy, red fur.
To be continued…
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