Tuesday, July 1, 2014

Twelve Staples Later

We're not sure how he fell.

But there he was, at the foot of the steps leading up to our wide patio door, splayed across the concrete, his little transistor radio in a couple of pieces a few feet away, and his eyeglasses another few feet further away.

I rushed down the four concrete steps to his side, quickly maneuvering to his head, telling him not to move.  Mom was on the phone, calling 911.  I think I prayed, but frankly, I can't remember.

It was Sunday afternoon, about a quarter to four, this past weekend.  The temperature was in the mid-90's, but on the concrete, it felt like we were being baked alive.  A giant magnolia tree towers over one side of our patio, but it's the north side, which is of no use in blocking Texas' incessant sunlight.  Dad complained that the concrete was too hot, and even though he was wearing pants, it felt like his legs were burning.

Okay, he can feel his legs, I had the presence of mind to realize. That means he's probably not paralyzed.

I told him to lay still, but he started moving his legs anyway.  Okay, he's stubborn, but he's not paralyzed, I told myself.

Then the blood began to spurt from underneath his head.  Mom came to the sliding glass door, a phone in her hand.  "He's bleeding profusely!" I yelled.  "A lot of blood!"

Mom got a towel from the nearby kitchen and tossed it to me.  How long had she been on that phone with 911?  I didn't hear any sirens.  I wrapped the yellow hand towel around Dad's head.  It quickly turned red.

"Keep talking to him," Mom instructed from the patio door, relaying what the 911 operator was telling her.

"Dad, you'll be OK," I said grimly, not sure to believe it myself.  No grand theology, no deep thoughts, no insightful advice.  But now I remember praying to myself.  "Please, Lord, keep Dad OK."

I had been fearing such a moment for a couple of years.  I'd even been researching contractors and getting quotes on having a handrail installed on the patio steps.  And now it was actually happening.  Was this it?  The end?  For some reason, I didn't think so.

Finally - after what everybody else in these types of situations says seems like an eternity - I could hear sirens.  And soon, the banging of aluminum doors on the other side of the house, and I could smell diesel fumes.  Clomping through the side yard came a herd of young men:  blue-suited EMTs from the ambulance, mixed with tall guys in yellow overalls from the fire department.  They swooped in and took over, like it was all in a day's work... which, for them, it was.

A pneumatic stretcher appeared, along with a long, blue flat board.  A neck brace, straps; the men worked methodically, yet with gentleness.  They spoke calmly, efficiently, asking Dad questions in such normal voices that he, being hard of hearing, sometimes couldn't make out what they were saying.  Before long, they had Dad strapped to the flat board, which was then strapped to the big, yellow stretcher, and they were taking him back around the side yard, to the waiting ambulance.

I think Dad spent more time in the back of that ambulance, idling by the curb as they prepped him for transport and communicated with the hospital, than he did actually laying on the concrete.  Mom sat in the ambulance cab, and the firemen stood inside their truck, taking off their bulky, fire-retardant overalls.  I didn't even hear the fire truck pull away.

We spent over six hours in Arlington (TX) Memorial Hospital's sprawling Emergency department, huddled in our own private room off of the department's main hallway.  Since Dad arrived by ambulance with a head injury, the only delay we had was while an orderly quickly finished cleaning and clearing the small room from its last patient.  Mom and I never had to sit out in the waiting room, although after a while, I began to wonder if the chairs out there were any more comfortable than the thinly-cushioned ones in our little private room.

Nurse after nurse paraded through Dad's room, attaching some medical things onto him, but mostly typing information into their computers.  Dad's head kept bleeding - dripping - for several hours; a small pile of red, sticky gauze pads accumulated on the floor, along with drops of blood.  But none of the medical professionals seemed to care; afterwards, Mom and I wondered if they wanted to see how much - and for how long - Dad would bleed.  A neighbor who's a nurse has told us that with head wounds, as long as it's not a steady gushing of blood, bleeding can actually be good for the brain.  It can help prevent fluid-buildup under the skull.

When the ER doctor first examined Dad, he was all-business and quite serious.  His words were few and clipped.  He ordered a battery of CAT scans, and tests to be run on the blood a nurse would take from his vein.  I thought about helpfully picking up one of the gauze pads on the floor and offering it to the nurse as a blood sample, but figured that would be a tacky thing to do, all things considered.

Honestly, she took four or five vials of blood out of Dad's arm.  They certainly weren't worried about his losing any blood pressure!

My father is in his sixth year of dementia, and everybody who came into the room was treated to his exhibition of his left arm, which has a scar from a childhood accident back when he lived in Brooklyn.  Repeat visitors to his room were treated to the same exhibit, since Dad didn't remember they'd already seen it, and had already given the appropriate "oohs" and "ahhs" over it.  "I got that from a broken soda bottle some kid threw at me," Dad would proudly proclaim, every time.

Dad is a veteran of bad injuries.  That's what he wanted to tell everyone.

And he survived this injury, too - complete with twelve staples administered by the ER doctor, who returned to the room with an amazed grin on his face.  "You officially have a thick skull," he proclaimed to Dad with a flourish.

The doctor apologized for the wait, but he'd sent somebody out to Home Depot to replace their stock of staplers.  And with that, he produced a fairly generic-looking stapler inside a sealed plastic bag, but the joke was lost on Dad.  "I'm not getting stitches?"  Dad actually sounded disappointed upon learning staples would do the job better.

As we waited for the last batch of tests to come back, and the nurses had left the room, Dad began to get restless.  "Can't we just get up and leave?" he'd ask, despite his right arm and left hand still being hooked up to monitors.

Because of his dementia, he kept forgetting that he was in the hospital.  He completely forgot his fall, or the gash in his head, or the blood, or the ambulance ride.  Even today, he remembers none of it.  While we waited in the Emergency department, Mom and I kept telling him what had happened, why he was in the hospital, and why we needed to wait for the doctor's "all-clear" before we could leave.  And every time we told him he'd fallen, and about the firemen and the ambulance, and the 12 staples holding his scalp together, he'd look at us with surprise and amazement.  If it wasn't for the equipment still monitoring his vital statistics, he'd likely not have believed us.  He kept saying he felt fine.

Which, he probably did.  Dad has always had a high pain threshold.  One time, years ago, he walked around with a broken toe for a week before its incessant swelling finally convinced him to listen to Mom, and see his doctor.

In the rush to get him to the hospital, we'd left a pool of his blood back on the patio, and by yesterday, it had turned black.  We kept pointing out the spot to him, trying to see if we could jog his memory, but nope:  He'd look at us in surprise and amazement as we re-told the story of this past Sunday afternoon.

Finally, sometime today, when I asked him about the spot - that I've since washed away, leaving a faint stain - he remembered that it was his blood, from when he fell.  But the ER visit?  That's something senility apparently has removed from his consciousness.  Along with the reason he fell in the first place.

He fell backward, climbing up a short flight of steps.  Usually, when somebody stumbles while going up stairs, they fall face-forward, onto their knees or face.  Why did Dad fall backwards, and land about three feet away from the bottom step?

Back in the 1970's, his mother - who also suffered from dementia - had an aneurysm.  It happened while she was walking up to the third-floor landing of the Brooklyn apartment she shared with Dad's sister.  Without a sound, or ever crying out in surprise, my grandmother fell backwards, and slammed with a giant thud on the landing below.

It took my aunt about half an hour to find an ambulance company that would dare to enter her neighborhood, it had become such a dangerous place as white flight changed the entire city of New York.  That was also in the days before our modern 911 dispatch systems.  By the time an ambulance crew arrived, we learned later, my grandmother was dead, but because both the ambulance company and the hospital feared a lawsuit from my family, they transported my grandmother to the hospital and kept her on life support for several hours before officially pronouncing her dead.  Eventually, they told my aunt that her mother likely died from a sudden aneurysm, which is why she never called out as she fell.

The eerie similarities between her death and Dad's fall kinda haunted me a little.  But this time, God saw fit to preserve Dad, and restore him to us with 12 staples and some occasional dizziness.  He's not even very sore from the multiple bruises that are on his backside and shoulders, from landing on the concrete.  His eyeglasses didn't break, and Mom was amazed to discover that after soaking the shirt he'd been wearing in plain water, virtually all of the blood that had stained it came out.

So, we've still got Dad, his dementia, and the prospect of taking him to his primary care doctor next week to have those staples removed.

And Dad will probably be more animated over the scar in his left arm than anything else.

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