Cissy's Story

Scores of memories, not awakened to, but put into place by observers reviving their own memories.

The day began with my usual activity in New Orleans. Visit civil court first, then return to the 51st floor law office. I would go back with the firm's attorney who waited two streets over in his SUV to help bring file-stamped exhibits, color pictures and pages of argument rewriting the case's never-ending story. These pleadings I put into carrying order, behind me in a cart, too abundant to be simply held and walked.

On the morning of that date, October 23, 2014, a large white truck rammed from behind, sending me up into the air. After I fell, in the middle of one street bordering the courthouse, a local crowd gathered, outdoor witnesses, and also including those from court having seen this through the windows. Two policemen approached from where they worked downtown on horses, then both a firetruck and ambulance appeared, having been summoned by the police. One policeman dismounted to write a ticket, but could not completely describe the situation because it became necessary to remove me, the unconscious woman, by ambulance to University Hospital Emergency, located downtown close by us. The truck driver drove himself into tears. He had admitted to the police that he lacked any insurance. This lack did not apply to me, because I was at work when the accident occurred, and worker's compensation insurance applied to me. The firm's insurance paid for me entirely, from in-patient to out-patient status. The law firm was unable to attempt recovery of any funds from the man's non-existent insurance.

My husband arrived at University Hospital from his federal court hearing, after being notified of the accident. The federal hearing was continued for weeks. My husband was not allowed to see me, until hospital employees could clean their new patient. But he said he magically observed his wife before the clean-up was actually finished. I wore hospital clothes, not bloody and standing in front of him indicating with hands and facial expressions not to worry. He did not in fact enter my room for an hour, after he experienced this vision-like appearance, and I was not conscious when he did finally see me. All of my suit clothes, watch and rings had been removed to the hospital's safe. The staff underwent life-saving procedures, keeping me breathing in a head-cover with oxygen passing through my nose and throat. This became a long night, then several nights, during most of which he eventually went home. Our son joined daily after being dismissed from work.

The first night, my husband requested his wife's jewelry, and was told she should ask for that herself when able. Knowing this official advice to be doubly improbable -who knew about her survival or her physical and mental abilities following that. He asked for a hospital employee and a guard on duty to come with him to help identify, and organize his wife's personal belongings, so he could claim and remove them. He took his son that evening for the first of their many restaurant dinners. Word of these difficult events spread through Dallas, New Orleans and elsewhere, to family, work-places, friends from church and synagogue, all offering their emotional comfort, prayers, visits.

[In my own consciousness, I had a vague ability to observe some of what happened to me. My distance was extreme, and seemed to me peopled by my deceased mother. I sensed her strong encouragement for me to remain alive.]
My two weeks at University Hospital saved my life but not my sensibility. My husband had to look for another healing hospital and rehabilitation facilities because University offered no such services. Life became for that facility breathing and the ability to swallow, but those beds and staff always awaited the next life-threatening emergency. After a move to a local uptown hospital, during recovery for me as in-patient, a rehab search was made by my husband throughout Louisiana and Texas. What seemed like a miracle to him in his emotional panic, and was a positive surprise to other family members, the uptown facility intervened to offer me their own out-patient rehab facilities. Close to my home neighborhood, they had proven to be my healing hospital, and then they offered subsequent rehabilitation doctors, nurses and therapists.

I slowly awakened, intermittently, in the hospital during in-patient recovery, in November and December of 2014. I first recognized visitors other than my husband and son. They came from my work-place, members of the maritime legal department. Only one attorney, my accident-day companion, did I completely recall, while for others I needed names, descriptions. But my remembrance of this attorney is that we had a long conversation, until it became clear to him that I spoke nonsense. I thought we were having a humorous exchange, laughing, but he left saying “good night, until later.” At least he would return.

I knew that rehabilitation would focus on out-patient abilities I might achieve following near-fatal physical blows to my head and to the left side of my body. Therapy would address brain injury resulting from my skull fracture. My cognitive skills would be tested by speech and neuropsychological specialists. My physical movements were supposed to improve via exercise and gym machine therapy.

As an in-patient staying overnight in my bedroom at the hospital, I swallowed thick liquid with complete discomfort, but it was given to me for safety. I was told I would choke on thin liquids, but I felt oppositely, that thick ones tasted bitter and obstructed my throat. I sneaked tap when I used my room's toilet, and had visitors walk me by hallway water fountains. My restroom door was soon locked unless I needed to use it, always with help. Fountains remained available for me, with visitors.

I realized I was slowly training for a return to regular life. Two speech therapists worked with me to express my thoughts, to achieve for myself an understanding of such thoughts. I practiced traveling up and down stairways with nurse personnel, often with my husband and son who also threw balls to me over the roof's volleyball-type net. But I also slept a good deal, according to friends' reports. “Every time I come you are asleep!” wrote one. Walks nearby to snack on burgers and fries with visitors were happy outings for me, but disapproved by the hospital. With meals in the hospital or anywhere, I looked physically as though I never ate at all. Medical staff wanted to tube-feed me. My husband insisted that I “please eat,” under such circumstances, and I followed his orders. Some weight returned.

My Dallas family, not regularly seeing me, weren't aware how much I had recovered nor how much help I still needed. They devised plans for me to follow other than rehabilitation, either staying with them or in a living-assisted home, because they believed me to be injured beyond repair. Only in December when I sat quickly up in bed, speaking loudly and normally to my visiting brother, did he recognize my“self.” “There she is,” he said to a nurse. This was when he realized that my in-patient hospitalization was about over. The next step would begin for me, when I arrived at rehabilitation from my house. My conversations with rehabilitation personnel began just before Christmas, the week family expected me, my son and husband to make holiday travel to Texas. I had agreed to a

“Rehabilitation Attendance Contract” and I started that program December 22.Meeting with me, the dark-haired neuropsychologist looked as though he thought me full of gibberish. I described experiences such as country visits 90 miles east of Dallas, and vacations by private plane to Cancun with college friends. By our next session, he seemed to believe I had spoken “truly”of these events.

I met on a daily basis after Christmas, from 9 am until 3 pm, with the neuropsychologist in his office administering and monitoring mental testing and our discussions, with a speech therapist for oral and reading exercises in her office, and with many athletic physical trainers and their equipment in the gym. I spent much time in the kitchen and the nearby located patient lounge with a therapeutic recreational individual. She talked about her work in many other areas of the hospital. Her schedule with me focused on working me back into the city community, by introducing a variety of activities, in the kitchen cooking with other patients, out together at lunch, shopping together for kitchen supplies, playing card games. I did not fully understand her social goals. I felt a personal goal: get back downtown to work. As rehab time passed, only the speech therapist seemed to keep in mind my personal goal. Many other patients had been in this rehab program for months, possibly being expected to stay for several more.

My speech therapist taught me word-finding strategies, for using when I couldn't say the right word at the right moment. It reminded me of school, substituting synonyms with similar meanings for words, and I still use this technique when I become frustrated communicating and trying to say or describe something. “Car” for trip, “type” for letter, “smile” for joke, not always appropriate, but wanted quickly. This therapist had me read parts of newspapers and describe or write about their meanings, but eventually we were discussing newspaper articles about city events, local elections. She left to take a new job, and told me that it might be time for me to finish rehabilitation as well.

Gym therapists encouraged riding stationary bikes, traveling stairs and walking hallways, lifting weights, lying down in positions for stretching. I took home a drawn exercise program to continue, knee to chest, abdominal bracing, lumbar training, movements familiar to me. After rehabilitation, I used the program at home, and often at my gym.

I requested help from the neuropsychologist while still an in-patient, approaching him in a hallway from my hospital room. Although I didn't remember this action, he described it to me. I tried to understand but I thought the action went beyond my usual personality, to seek help approaching a doctor in that manner. His help came in the form of my reading a variety of stories and articles, and describing them to him or identifying words contained in them. I could write from certain texts, using a pencil. We discussed my work and personal life, including special activities such as a lunch with California friends in town, which lasted an entire afternoon into evening.

On January 20, in his office I stopped expressing myself at all. I thought it was a good idea to remain silent, because there was nothing for me to say. Staying silent I went straight with the psychologist to rehabilitation's first floor where I was screened for a possible physical loss of balance or stroke. I then went with rehab personnel to the hospital's emergency room. I stayed silent there for another hour, while movement and breathing tests were given. My husband arrived during the testing period. My behavior was not described later as a seizure. “No Diagnosis Data Found” appeared in my discharge paper when I went home the following day, as the hospital had wanted to watch me overnight.

The rehabilitation continued daily until approximately mid-February, when the schedule changed, and I met for therapy every other week-day. Monday, Wednesday, Friday were sending me towards a return to work. I became analyzed for that return, differently by each therapist, and by another physician who interviewed me at her office. Some therapists were positive, some not so much, for my change.

My therapeutic recreation became more intense, being put in charge in the kitchen while cooking, handing out utensils and designating pots to use. This therapist and I visited different parts of the hospital, to talk with nurses and healing staff, to discuss their meals and schedules. She told me I was not at all ready for work yet, but she gave me tasks that might help. We took two hours for lunch and walked many blocks to and from the hospital. We discussed and reviewed housing, street shops, and restaurant destinations in neighborhoods around us. She allowed me, rather than the hospital clinic, to pay for our lunch at a location which I chose, one week before my departure, and she encouraged me that day to “come see” her if I felt that became “necessary” in my life outside of rehabilitation.

There were three newly hired speech assistants who each saw me once per week. They wanted me to discuss work and computer skills. Was I still competent in Word and Excel, could I manage Summation? I was graded by them, on my understanding of office-type situations such as early or late hours, and recording 8-hour billable days on required, descriptive time sheets. These assistants believed I might be ready to begin working, but still needed training by office assistants, other paralegals, and attorneys for my job's duties.

Gym therapists recorded my scores which they showed me, based on balance and strength, leg lifts and push-ups. I had improved, very obviously, from my earlier days when stretching was the most proficient “exercise” I accomplished. They advised me, “keep your physical therapy going,” as I had expected.

At a meeting with worker's compensation representatives, which all of the therapists and I attended, the neuropsychologist gave his opinion that if I wanted to resume paralegal work, I was in a reasonable position to try that. He had completed testing of me, and pulled articles to review such as studies of the ALS disease undergone by my sister-in-law. The reading and discussions, and some writings continued. He selected items of interest from his own magazines, and spent time doing this when we began our meetings, for me to read something other than the usual. Different articles were about disruptive cognitive functions, and where they occurred in one's brain during the aging process, or about other psychological professionals and their activities.

Finally, regarding my more complete medical history, I saw a “Board Certified Physical Medicine and Rehabilitation” doctor, and I received her full evaluation in mid-February 2015 before attempting to return to work. She had studied paperwork about my accident, and its resulting brain and skeletal conditions. She read written impressions from therapists about my rehabilitation efforts. Specific questions were presented in a memorandum by my worker's compensation carrier. She had reading knowledge of me by reference to these studies, and from in-patient medical reports given to her.

She learned related knowledge of me from our comprehensive conversation in February. She asked specifically about my lapsed memory of the accident when it occurred, then how my memory of the accident developed during subsequent treatments, particularly those with outpatient, rehabilitation therapists. The worker's compensation carrier had questioned how I would continue rehab proceedings, what kind of treatment would she recommend, could I fly or otherwise travel, would cognitive psychological therapy remain appropriate, should I return to work. The examination became lengthy, for the entire afternoon of questions and description.

This doctor did not provide her answer to the compensation carrier's work question until mid-March. Her advice at this time was for me to work only one half-day per week, while still receiving rehab therapy. In her medical opinion, I remained unable to return to full paralegal duties, until she continued to examine me in the coming weeks. The law firm's human resources supervisor responded in writing that such a proposed schedule was unacceptable. The supervisor wanted additional explanatory information from rehab doctors and therapists, about my condition, and why I could not perform full duties.

At the end of March, the same Board Certified doctor re-answered the work question with a completely different response. She wrote to the firm's human resources supervisor, and to the worker's compensation carrier. I had been “released to return to work as a paralegal, without restrictions” beginning immediately one day the next week, increasing one day per week, until I “should therefore transition back to full time work over the next five weeks.” This doctor had conferred with my therapists, and provided the revised advice based upon those conversations.
My rehabilitation was therefore complete.

The first day back at the office began in April, when I received surprised and happy greetings from fellow workers, attorneys, paralegals, secretaries.

The human resources supervisor arrived first at my door, certainly not surprised. The supervisor told me that my accident-day attorney had not allowed anyone to touch or clean
this office during my absence. Surely enough, my office contents looked exactly the way everything had the day I became injured, down to October 23, 2014 correspondence. One day at a time, I returned to the firm.

The third clinic day was in place, and I prepared an Italian lasagna lunch on April 20th for the recreation therapist and patients in the kitchen. I met with the neuropsychologist early that afternoon, but I must have shown a staring spell and loss of awareness, because he immediately suspected an oncoming seizure. We went downstairs, although I argued with him that we needn't do that. I knew I was leaving the clinic, and didn't want this occasion to interfere with that. Once again I was tested for stroke, with looks at my eyes and body movements, and taken to the emergency room where I was quickly met by my husband. There was no doubt that others recognized my seizure, but it did not last long and I went home the same day.

The physician assigned to me through worker's compensation saw me the next morning, and prescribed Keppra for seizures, to be taken twice a day beginning that day. He told me to resume my usual clinic and work schedule the next day. I felt very unsure and unhappy about continuing office work. Because of these feelings, the following day I pretended illness and did not start my day with therapy. My husband insisted that therapists still wanted to see me. I feared their treatments would continue for a much longer period of time than two weeks, and that my driving would be canceled. I attended that afternoon, because I had to be told about my new schedule.

I was somewhat correct about the driving which would occur later, in 6 months because of the seizure, but therapy continued exactly as planned earlier. The neuropsychologist asked rather irritably why I stayed home that morning from therapy, and wanted to know why I thought my seizure would delay a return to work. We discussed medicine for seizures, and he gave me literature about Keppra. I again received physical gym therapy, and spoke regarding work duties with speech therapists. The clinic's remaining days passed quickly, and I signed release forms. I would return in six months for a street driving evaluation. I set days on my working calendar for each of those months, to mark my eventual release from the drivers provided by worker's compensation.

The law firm's schedule, relying on billable time for monthly presentation to clients, was recorded by completion of the firm's time sheets. The time sheets continued with the same cases never really forgotten in the hospital. I recorded .70 percent of one hour for reviewing a revised summary of settlement offers, in pleadings which were filed on the accident-day. I spent a whole 1.00 hour to review maps and compare them with newspaper articles, reminding me of speech therapy. I took Keppra twice daily, once at home, then again at the office, and referred to Keppra literature provided by the neuropsychologist.

I felt absolutely “ready” for work as I had declared at rehab, and made sure to complete time sheets reflecting my presence and full 8-hour or longer days. However, that billing time reminded me daily of “accident time” in every way. I was reminded either privately in thought, or by others looking out of my window upon a street scene next to the courthouse, where the accident had occurred. They showed curiosity about vacations for me, or when I could return to Texas, subjects pleasant to discuss, rather than being asked how I still “felt” physically after being hit so hard.

After six months, I returned to driving. The worker's comp drivers no longer took me from home to work, work to home every day, so normalcy returned for me. In November, while I performed discussion over the phone regarding a house loan and costs, I experienced the same kind of jolt as I had on April 20th, a genuine loss of communication with another person. I quit the phone conversation. I then suffered another seizure at my desk, one which I had known slightly in advance would happen. I fell out of my chair from the desk. I was of course discovered, taken to an emergency room and met there by my husband.

The worker's compensation-selected physician immediately prescribed another medication, Vimpat. He considered Vimpat more completely effective than Keppra, even if it proved to be very expensive. That cost would be covered for me by worker's compensation insurance.

Being back in the office, taking new medication and recording billable time each day, extended working years for me.