Thursday, February 17, 2011

Head Rest (One of Those Nights)

Last night at around 9:00pm, I got a call from my parents’ assisted living facility that my dad had unfortunately been standing near two men who had gotten into an altercation, and that my father was pushed down and hit his head on the side of a table.  They said he looked okay, with the exception of a knot on the back of his head, but that they wanted permission to send him to get checked at a hospital.  They also asked me if I thought they should tell my mother.  I thought that since it didn’t sound serious, we’d save her the panic, and the staff the annoyance of her panic, and just tell her all about it in the morning.  I said, “yes,” to the hospital check of course.  Sounded like a really good idea for an eighty-two year old who had just hit his head in a fall.  And after a few more minutes, I got a call from the facility telling me where he was being shipped to by ambulance; one of the better hospitals in Los Angeles.

I drove to the hospital and, after some scrambling around to figure out where exactly the emergency section was, I was walked by a hospital monitor to my dad, who was laying in a gurney, staring out blankly at the goings on around him.  His gurney was parked on a tangent with a busy hallway; a kind of triage alcove.  My dad’s was low on their priority list.  I don’t say this to be critical of the hospital.  They had a lot going on, and really, my dad just had a bump on the head.  So we waited.  We waited from 9:30pm until about 11:00pm. 

As I sat down next to my dad, I noticed next to us, just beyond a privacy screen, sat a young Asian woman; probably mid-twenties.  She had a pink top, blue jeans and sandals on.  At one point, she said something to a nurse, and there was suddenly a flurry of activity just beyond where I could see.  The result just a few minutes later was the removal of one of those bed bottles.  I think her grandmother, who was in the gurney, had needed to go to the restroom so to speak.  This girl who was doing the waiting, was young, and I thought, looked forlorn, as if she had suddenly thrust into a situation with no additional support. I guess everyone felt that way sitting in the area we were in.

Another couple came in about thirty minutes later.  Also in their twenties.  The boy was consoling the girl, who was crying almost hysterically for at least an hour.  I lost track at some point.  But I wondered what had happened.  Had a friend been in a car accident, or maybe hit walking across a street?  Or maybe this girl that I was looking at had herself overdosed on something; I heard her saying something about medications.  Oh the stories that must go through this place every night.

During that time, I sat in a chair next to my dad, and we talked intermittently.  His Alzheimer’s steers his conversation from focused, to vocalized distracted thoughts, and back again.  His vision plays tricks on him; I can tell.  The way we were positioned as we were waiting, we faced double doors about twenty feet away from us, and at times, he reached out with his hand to touch them.  Without asking him, I could see that he had the sense at times that he could push the doors open from his bed.

So our conversation was one of touching on topics of the past, mixed with goings on around us.  At one point, I thought I was about to hear some morsel of information I had never been told about by him.  He started telling me a story about how his visits up at the Hughes Aircraft Malibu Labs involved running into a man occasionally that was looking at beach homes, just as my parents had been doing at the time.  My dad said that he had several interactions with this man and that, unbeknownst to most people, Hughes Aircraft owned a lot of the residential properties on the beach front, and that this man had learned secrets about the company involving early laser development.  A few more facts and events thrown into the story, and I realized after a time that this was a total fantasy of my dad’s, in his Alzheimer’s fog.  Several times, he started to say something, and then he stopped, and said, “Oh, I lost it.”  Thoughts from his real past combined with his fantasy life, floating like partially translucent images on thin membranes of resin, which break up and dissolve.  I thought about how I would not want to switch places with him, and that maybe someday I would be in his place anyway, but how glad I was to be sitting by his side keeping him company.  I wouldn’t have wanted him to be alone there.

Throughout our waiting, a dark-haired, thin, thirty-year old nurse stopped by several times about forty minutes apart to take his blood pressure, which remained high.  He’s always had high blood pressure, and that evening’s fall and activity all around him had pushed it yet higher.  The nurse started to take his blood pressure again when my father suddenly said, “I have to go pee.”  The nurse said of course, as soon as the BP reading was done.  He said, “No, I have to go now, or I’m going to go where I’m laying.”  The nurse and I realized he meant business, and so we got my dad’s rigid body rotated with his legs hanging off of the gurney so that he could get up on his feet and walk.  Being stiff from lying so long meant that the nurse and I had to support him pretty tightly to keep his walking stable over to the bathroom, which was directly across the hall from where we were.  Without going into detail of getting him set to do his business, I’ll say that I was embarrassed for both my father and for the female nurse for having to go through such an ordeal to let him do what he needed to do.  She does this every day, I’m sure, but it’s hard to see a once strong, independent man, be so unable to do the simplest of things.  I think the real embarrassment was from my own not knowing exactly how to help him.  I felt like a useless third wheel.

Shortly after we got my dad out of the bathroom and back on the gurney for the completion of his blood pressure measurement, a young, clean-cut, male medical student checked my dad’s head and asked him a few questions, such as, “How did this happen.”  My dad said that someone hit him with a wrench.  The medical assistant looked at me, and I mouthed, “Alzheimer’s.”  My dad also didn’t answer questions about his taking blood pressure medication correctly, but by then, the medical assistant was onto him and got most of the information from me.  After briefly examining my dad's nickel-sized abrasion on the lower back of his head, he told us he was going to move my dad to a room down the hall so that they could expedite things.

This room faced smack onto the trauma unit’s nursing station.  Busy with charts being grabbed, written on and replaced.  Nurses on telephones, doctors putting data into computer terminals.  Non-stop activity.  I still feel a kinship with this environment from my early working days as a psych tech at various psychiatric hospitals.  The patients are different, but the routine is still familiar to me.

We received, as if on cue, two young nurses, both of whom found my dad pleasant, compared to some other patients nearby rooms that night who were apparently not so nice.  It’s funny at his age that women still seem to know instinctively that flirtation is the currency that is easiest to use in interacting with him.  It makes me giggle.  They asked him questions of how it all happened, and when my father said again that someone crept up behind him with a wrench.  I had to burst out laughing this time.  It was just too much.  The stress of seeing him in the trauma ward, the Alzheimer’s, and the late hour it had become had affected me.  I gathered myself and said, “Dad, nobody struck you with a wrench.  You just fell down and hit your head.”  The nurses were amused as well, smiling.  My dad told them, “Listen to him; he knows the story better than I do.”

The nurses put an IV in my dad’s arm, succeeding only after a few tries with smaller and smaller needles.  My dad apparently has large values in his forearm veins.  Maybe it was from all his teen years scooping ice cream I thought to myself.  The nurses, before leaving, showed my dad a light gray cable with a red button at it’s end, which slung over the gurney rail, saying that if he needed anything, he should just press it and they'd be there for him.  My dad didn’t seem to really “get” the purpose of this, but that was fine.  I was there.  They said they would send my dad out for a CAT Scan. 

In about fifteen minutes, sure enough, a young Latino man came in and rolled my dad’s gurney out and down the hall.  I sat for a while, trying to calculate the anticipated slowness of each of the processes that would still need to occur, and when I would be home again.  Well, maybe 1:45am?  No, probably more like 2:15am.  The fact was, I just had no idea.  But it would have to involve getting my dad out of the hospital with his very slow gait and moderate confusion, into my Jeep, and then up into the assisted living facility.  I walked down the hall and used the bathroom, and upon returning to the trauma room, my dad was already back.  He wasn’t perched up with his backrest anymore, but rather was lying flat in a kind of asymmetrical position, and looking so much smaller and grayer than when he was “my father.”

About this time, I started noticing announcements on the intercom every twenty minutes or so. “Trauma victim being transported by air support coming to trauma unit.  ETA 7 minutes.”   “Two trauma victims being transported by patrol from same accident.  ETA 16 minutes.”  This had been happening for a while, but it had finally made it through my subconscious chatter.  So these had to be car crashes, shootings and overdoses at this hour, right?  What else?  People were being rushed to this trauma unit as fast as humanly possible with the possibility of dying to get their lives saved.  Wow!  I mean like, really WOW!  That’s quite a job these people have.

I sat in the chair next to my dad continuing the long wait for the tests to come back, which I was almost certain would find that the head bump had no affect on my dad.  And now the hours slowed down.  12:50pm, 1:30am, 1:45am.  At 2:20am, I pulled out my cell phone, which didn’t have such good reception within the solid hospital foundation around me, and I text a message to my home email address saying, “It’s 2:20pm.  I’m still here and I’m tired.”  I did this because it helped me to know that at some point I would be reading the email on my home computer, and it would all be over.  I’d be in my warm home and not sitting in a cold, sterile hospital anymore.

Just then, an admissions person came in with a clipboard and asked me about insurance.  I said that the assisted living facility had all of that stuff and that I didn’t know any of it by heart.  He said that he could probably fish out what he needed from the computer, given some previous visits, and then get the rest tomorrow.  I was so tired that I don’t know how we made this transition, but I found myself telling him about a taco stand on Vineland and Strathern in the San Fernando Valley called, “Daniel’s Tacos.”  “It’s great,” I told him.  “Any time of night, always people there gobbling down tacos.  And when the police eat there on their breaks, you know it’s good.”  This fellow wrote down the intersection on his clipboard, “Vineland and Strathern.  I’ll give it a try.”  I supposed that these spontaneous topics were commonplace within the inebriation of sleep-deprived awaiting family members.  This was all par for the course for this gentleman’s late shifts.

At 2:40am, the radiologist came in and said that she had looked at the scans.  They were fine.  But we had to wait for the lab work.  Wait, wait, wait…falling asleep in my chair.  An occasional look at my father, who seemed to be drifting in and out of sleep to a state of half focusing on things in the hospital room.  Then, at 3:00am, the nurse came in and said that she had gotten the lab work back and that it all looked good.  She brought in some discharge papers and follow up instructions.  I told her I had parked my car in the “regular” hospital parking, and asked if the valet would bring it over.  She said no, but that if I wanted to pay for the parking and bring my car around, she would help my dad into his clothes, get someone to bring my dad out of the emergency drive in a wheel chair.  That sounded really great to me.  Thoroughly exhausted, I welcomed the idea of other people helping get my dad back together and deliver him as a package to me at the exit doors.

A young, Asian man wheeled my dad to my Jeep as I drove up.  We helped my father into the car, and as we did, my dad asked the two of us, “Where’s Fred in all of this?”  I said, “I’m right here, dad, holding you.”  He probably couldn’t see well in the dark, and as always, the confustion.  We drove to his living facility and luckily when we arrived there at 3:20am, there was someone at the door who also offered to get a wheel chair, and off we three went up the elevators to my dad’s floor, where waiting were one nurse and another staff floor-worker.  They got my dad into his bed, which made me feel relieved.  He was back, his head had been checked, and he was safe.  My mother would undoubtedly hear the story in the morning, after it had all been done. 

And so I left and drove on freeways, which at 3:30am, have almost nobody on them. I turned on my Bluetooth ear-piece, called Bob’s Big Boy and told them to cook me up a cheeseburger with rice for pick up.  I got home, ate my cheeseburger and put some soy sauce on my rice, drank a mug of cold water down, and as my head hit the pillow, the green numbers on my digital clock read, 4:40am.