Phase Two: Rehabilitation.

Where to Start?

I’ve thought long and hard on how to put the next nine months in any semblance of order.  First, like the previous month, my memory of events is, at best, sporadic.  Luckily though I have some notes.  Yes, that is right, I actually kept a bunch of notes that I took while in different segments of my rehab and, of course, the mounds of homework we were assigned.  So now I can, at my leisure, read them again and…, try to make sense out of the situation.  But to start at the beginning of this phase of my life I will skip to the end and cut and paste part of a thank you letter and, an apology of sorts that I wrote to Julie, the woman who was, more or less, head of the cognitive rehabilitation section of my treatment schedule. 

I first arrived at the Kessler Institute as an outpatient in the second week of January 2008 which was, roughly speaking, a week or so after I was discharged from the Rehabilitation Institute.  I had no idea what was really about to happen.  I did have an understanding that physical therapy was on order and that I knew I was in need of.  At the time it was hard for me to walk fast without fear of falling.  I still had no inclination to climb stairs and the left side of my body was very, very stiff, especially in the left shoulder area (and neck).  I did not know what occupational therapy was, or that I was being scheduled in, but the most difficult exposure for me was going to be ‘quality’ time with a very young woman (Erin) who was going to help me …, what?  Talk again?  I had no idea, and how could someone with my background be forced to sit with what appeared to me to be a teenager so that the youngster could grade my progress.  Boy was I pissed off…, I looked across the hallway and there was a group of adults seemingly having an interesting discussion on something (anything) but I was sitting down in a room with this young girl who was telling me how to… I’ll let the ‘apology’ letter take it from here.  This letter was written in late July of 2008, just a few weeks before my discharge from the rehab program…, so now I have to wonder, did I write it to make sure they let me go?  Anyway, have a look, and let me know what you think.

Dear Julie,

It is always hard for someone laden with (or is that dominated by) male ego to put the appropriate words upon the parchment.  But herein is my effort. 

I want (need) to thank the entire Institute, those that I came into direct contact with (some of whose names I can actually remember) and the rest of the organization that has put such an effective team in place.

First I must tell you how sorry I am for any behavior I may have exhibited towards Erin, for any angst I may have caused her.  Of course it is my fault, not hers, and on many days I attempted to gather enough courage to apologize to her in person, but for various reasons (cowardice being number one) I chickened out.  My case was placed on her desk well before my cortex had a chance to re-assimilate in the direction of reality, and without the buffer zone in place it is hard for someone with an ego as large as mine to behave appropriately.

Julie, as I remember from our first tête-à-tête (this I do remember), Erin wasn’t the only one I pissed off.  You did the right thing and gave me a piece of your mind and that, of course, helped me figure out a new game plan; A plan to help me survive in the ‘Brave New World’ in which I existed.  But seriously, you are a bit older than Erin, so you had a good, better, experienced response to someone in my state.

In the early days, I had the most success with those who were not challenging me to re-establish my cognitive processes.  PT was, in my mind at the time, the most important issue and therefore my time there was very important.  That is why I want to thank John and Aaron and Cindy and Leigh and the blond girl who I had most often but can never remember her name (my memory still isn’t, and probably never will be, functioning normally).  They were all positive help for a man who couldn’t walk well when he started. 

I also have to thank Doug in OT.  I had some of the others in OT, like Catherine, but there were so many different workers in and out who helped me in a sporadic fashion that I tend to meld their names together, or like Aaron’s wife’s, people I know but whose names I cannot keep in my head.  Doug I remember well.  He always seemed to treat me like a human being, even on day one.  It may have been his special training, or just a productive embellishment of his normal personality.  Whatever the reason, from day one I felt safe being around him and I have always believed that his efforts helped me adapt to being at Kessler.

Now for the CRP (Cognitive Rehabilitation Program) group.  Obviously it wasn’t a walk in the park for me, or for your group, in the beginning (we can ask Erin about that, eh?), but as I’ve said many times in our ‘family’ meetings, it is beyond my ability to work constantly with people in a one-on-one environment.  Since it was beyond my ability before the accident, it added to my awe as I watched the Kessler people go about their daily work. 

Without sounding negative against any one type of session, I have to say at various times I enjoyed particular sessions more than others because they allowed me, or helped me, to figure out exactly where I stood in the grand scheme of things.  People with my ego have to figure things out for themselves.  I remember the psychologist Tom, the one who moved out to ND (or thereabouts).  He helped explain issues relating to the cerebral cortex, such as it needs to re-engage itself after an accident and just like that I began to understand so much of my own inabilities at the time.  Understanding is an important component of the ‘settling-down’ process and once ‘settled’ the ability to ‘re-engage’ takes place so much more efficiently.  And of course, once I settled down I could appreciate all that you, Jane, Denise and Basil were trying to accomplish.  It sometimes takes a while to get one’s brain to adjust to the circumstances, and I am sorry for the amount of time it took mine.  But then, of course, if I took a group of Kessler instructors along to work with me for a few days, my thinking is I would have a few people less than happy being outside their normal environment too (a joke).

What I always found most rewarding during my sessions at Kessler was the ability to sit and talk with the other survivors.  This type of interaction builds camaraderie of sorts and allows one to see that they are not alone, and therefore, the problems that have befallen, do not make one totally unique.  Most importantly, as the conversations I had with the others became deeper, I found myself trying to find a way to wiggle out from under the rock; that I was capable of human understanding, and was able to extend human emotions outside myself once again.

This leads to the sessions that I found most interesting and those were when Karen (Dr. Tennyson), whose name I will remember forever because I had to memorize ‘The Charge of the Light Brigade’ oh so long ago, was leading the group.  I also think that another psychologist (Sherry?) worked in a similar fashion when she returned recently to the Institute.  Group sessions, I’ve found out, are very helpful when you are trying to get people to rebuild their mental capacities, as sessions with you and Jane proved.  They are also very good when trying to get people to understand and overcome their psychological handicaps.  I also feel it is easier to overcome issues with problematic cognitive processes than it is to ‘fix’ psychological damage, but most importantly one needs to put these issues out into the daylight for a good look.  This helps the incessant need to combat these demons moving forward.  This is what I think Karen’s sessions did for me….

There is a section here in which I spoke about my ‘writing’ but that is not for this posting.  If you want to read more about that, visit my webpage (http://www.comicfictionnoir.com/).

The letter ends with one parting thought:

Finally, no one who has suffered in the fashion that the Kessler patients have will ever return to the way they were before.  What can be hoped is that they return to the real world to try to experience life to their fullest capacity.  I will never be the same person, but I do hope that I will emerge to move positively into my new self.  I have to thank you, and the rest of your team for giving me this chance.

Keep smiling, it means a lot to people like me.

In my next post I will begin to discuss different sessions in the CRP classes.  Stay tuned.