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Chapter 1: The Brain Bomb Explodes

Brain, Heal Thyself: A Caregiver's New Approach to Recovery from Stroke, Aneurysm, and Traumatic Brain Injuries
Madonna Siles, Lawrence J. Beuret, MD

It is another astounding Indian summer afternoon in Door County, the northeast Wisconsin peninsula that juts into the sky-blue waters of Green Bay and Lake Michigan. The misty atmosphere virtually vibrates with the jewel tones of nature--garnet, sapphire, topaz, and ruby--all set in shimmering gold. No wonder Door County is the Midwest's artists? Mecca. The patio door of my harbor-side home is wide open to an unusually balmy breeze off Lake Michigan. I've been lured to my easel by the siren call of seagulls, lapping waves, and chirping backyard birds. Puffs of clouds are racing seagulls across the cobalt sky. Truly, this is paradise. Nothing can ruin my ecstatic mood as I paint the spectacular landscape I can see from my studio.

Earlier in the partly cloudy day, I had been moping around, still trying to recover from a weeklong bout with bronchitis. My housemate and best friend, Eve, had not too subtly suggested I get some fresh air by mowing the lawn before she gave the yard a final trim for the season.
Despite my initial reluctance, mowing turned out to be no chore at all. It was invigorating. As the sun claimed more and more of the sky, the temperature responded accordingly, eventually creating a perfect fall day. I even thanked Eve for getting me moving again.

Now I feel good enough to return to my painting, while Eve zips around the yard with her weed whip. As the birch shadows lengthen in the late afternoon sun, I am totally lost in the mesmerizing process of creativity. Certainly, it takes me several minutes before I realize that the weed whip is silent, replaced by anguished cries of distress mixed with the background noise of nature.

"Help me! Help me!" The words finally register in my mind.

Oh, Lord, I wonder if Eve has chopped off a hand or foot. Dropping the paintbrush, I race out of my art studio into the dining room.

I hear the cry again, but I don't know where it's coming from. Sound plays tricks in a lakefront house. I run out on the deck. She's not in the yard. Back inside, I fly through the kitchen to the front door. Nope, not there. Maybe the laundry room? Bathroom? Where is she? I hurry into the living room and peer down the dark hallway to our side door. There she is! Eve crawls out of the hallway shadows and collapses at my feet, moaning, "Help me."

At first, I'm frozen, then panicked. "What happened?" I shriek. "Did you cut off a foot?" Quickly checking, I'm relieved. No blood. Her legs and hands are intact. Thank God, I don't have to retrieve a body part from a bush.

Eve is crawling again to the middle of the living room. Now she's rolling around on the rug, legs thrashing, clutching her head in her hands. She's berserk with pain.

"What's the matter? Please tell me." I'm begging for an answer.

"Don't know. Felt like I was shot between my eyes. Fell to my knees . . . passing out . . . crawled in . . . God, the pain!" The words come tumbling out in one breathless rush.

I lean over and check her head. Maybe a stone hit her? Maybe a wayward bullet? It's deer hunting season, isn't it? Nope, no holes. Suddenly, she's quiet. I'm grateful for the silence. Then I notice that her eyes are rolling back. It appears she's losing consciousness.

"Eve, are you fainting?"

"Going to be sick."

"No, wait," I squeak, "not on the living room rug."

Like a raving lunatic, I run into the kitchen and fling open the cabinets, looking for a plastic bowl. An old one. What's the matter with me? Just go help her, stupid. Then a thought occurs. Hey, wait a second. This is probably just a migraine. Eve gets one every other month. Sometimes she vomits. Yep, that's what it is, a dumb headache.

I hurry to the living room and thrust the old bowl at her face in the nick of time. I close my eyes until she's finished gagging. Nervously, I check in the bowl. Uh-oh. It doesn't look like lunch, nor does it look normal. "Please," I beseech her, "tell me, do you think this is a migraine?"

No answer. She's losing consciousness again. She's never done that before.

I jump up and run to the phone. "Eve, is this migraine or should I call 9-1-1?" I wave the receiver in the air threateningly. Precious moments pass.

"Call," she says weakly.

As Eve passes out, I punch the buttons.

"Emergency operator."

"I'm not sure. I think we need help. An ambulance. My roommate hurt her head somehow. She's losing consciousness. I don't know if it's a migraine." I vaguely hope the operator will shed some light on my dilemma. "I think she's unconscious now."

"Where are you?" the calming voice asks.

"In Baileys Harbor." I recite the street directions. It feels like I'm talking in slow motion. "Yes, the driveway is on the right coming from Sturgeon Bay."

This is going to take forever, I think. Sturgeon Bay is 40 minutes away. But no sooner do I hang up than there is a pounding at the backdoor. Who needs visitors now?

I run to see who's there. It's the owner of a restaurant down the street. She's holding a duffel bag. Really, I don't have time to chat now.

"I just got the emergency call," she says breathlessly. "I'm a medical first responder. I know CPR. What's wrong? Is it your roommate?"

"Oh, yes, she's in the living room. Thank you. Please hurry." As I open the door, I see two more first responders running up the driveway. I wave them inside and direct them to the living room. Amazing. Where are these people coming from?

"Does Eve have a heart attack history?" a responder asks. "How about stroke?"

"No," I answer. "No!"

Now the three first responders are kneeling next to Eve. "Well, it might be a migraine," one says. "We need some ice."

I run to the refrigerator. Another knock at the door. Another first responder.

"Get some blankets," someone shouts. "She might be in shock."

I know I am in shock. I'm racing around like the proverbial headless chicken. I retrieve the ice from the refrigerator and run to the linen closet to find a blanket. Where are the damn blankets? Oh yeah, way up on the top shelf. I pull one and they all come tumbling down.

I hear the distant wail of a siren. Wow, that ambulance got here fast. Soon there's another knock at the door. "Paramedics," they shout in unison.

Armed with oxygen and a stretcher, they quickly take over. I'm crowded out of the living room trauma scene. Standing in the doorway, I feel so helpless as they call out more of the same questions. They're all shouting at Eve to stay awake. I overhear one of them talking to the hospital on his cell phone. "Might be a migraine," one paramedic says. "I don't think so," counters the other.

In the blink of an eye, they've strapped petite Eve onto the stretcher. The first responders rise in unison as they watch the medics cart Eve down the hallway and out the door. The first responders parade out behind them. As if it's an afterthought, one paramedic runs back into the house to talk to me.

"We're transporting Eve to the Door County hospital in Sturgeon Bay. You'll have to drive yourself." She turns and heads back to the ambulance.

As quickly as they came, they're gone. Standing alone in the kitchen, I'm not sure what to do next. First, I better change from my grubby painting attire. My hands are filthy. What a sight. The spooked cats, Ozzie and Lola, are meowing loudly for their dinner. My head's throbbing; I'm not over the bronchitis yet. Wish I had taken a nap earlier. I feel intensely sleepy; it's my own peculiar reaction to panic. Not a very helpful defense mechanism at the moment.

Robotically, I proceed through the tasks at hand. I'm unsuccessful at calming the cats, but I manage to divert their attention by throwing food in their bowls. Next, I ransack Eve's desk drawers, searching for the medical power of attorney documents. I haven't a clue where they are. Eve is keeper of the business papers. Eventually, I find the old Illinois power of attorney (POA), a relic of our Chicago past. It'll have to do. Finally I lock up the house and head to the hospital.

All the way to Sturgeon Bay, I browbeat myself. Why, oh why, did I call an expensive ambulance instead of putting Eve to bed? This will probably cost us $500 that we can't afford. Of course, it must be a migraine headache. She has a history of them. Eve was obviously overacting and, as usual, I am overreacting.

I hate to admit I'm so squeamish. My nursing skills are limited to fixing a cup of tea or dispensing an aspirin. If the situation gets any messier than that, I recommend calling a doctor. This time, however, my immaturity is going to cost us big bucks. I'll bet the ambulance crew was snickering all the way to Sturgeon Bay, making fun of the ditzy lady who cried "wolf" when it was only a lamb.

I arrive at the hospital and haul my bruised ego into the emergency center. A receptionist directs me to Eve's room. She is sitting up in bed, looking a little dazed. No one else is in the room. I fear that Eve's going to reprimand me for sending her off in an ambulance.

"How's your head?" I ask.

"It really hurts."

"Do they think it's a migraine?"

"Not sure."

Just then, a doctor bursts through the door, followed by a nurse. Two unfamiliar paramedics are trailing behind.

"Who are you?" he asks me bluntly. I explain that I am Eve's roommate.

He frowns. "So you're not a blood relative?"

"No, but I have this power of attorney paper." He smiles. Obviously, I said the magic words. He grabs the paper, and nods as he peruses the document.

"Okay, here's the situation. We've performed a CT scan and detected blood on her brain. Our diagnosis is a subarachnoid hemorrhage. We don't have the facilities to treat a cerebral hemorrhage here, so we're transferring her to Green Bay. First, we need you to sign these papers." He nods to the nurse, as he exits to answer a ringing phone.

"I'll sign," Eve pipes up in a meek little voice.

The nurse bypasses me and hands Eve the clipboard. Looking over her shoulder, I see Eve scrawl something. It sure doesn't look like her signature. I feel sick now.

The nurse looks at the signature doubtfully. "Here, you better countersign," she says to me. "And you look a little green. Why don't you sit down for a minute?"

The doctor reappears. "We've just received confirmation that a neurosurgeon is standing by waiting for Eve's arrival at the hospital in Green Bay. We've already called a long-distance ambulance company to take her."

At this, the two paramedics step forward to shake my hand. "I'm Rose. I'll be driving the ambulance. We want you to leave right now for the hospital. We?ll pass you on the highway with lights flashing and sirens going. Don't be alarmed, that's just the way we drive. You stick to the speed limit, understand? Stay calm."

"Can't I go with you? I don't know where the hospital is," I whine.

"No, you can't. Joe, here, is writing out directions for you. Now get going." She touches my cheek sympathetically.

Here, honey. Don't worry. I?ll be riding in back with your friend. I'll take good care of her, I promise," Joe says, as he gives my shoulder a reassuring pat.

I believe him. ...

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