Mark: From A to Z

When I arrived on Friday morning, Mark was locked inside his bed-cage, naked except for underwear, wild-eyed and yelling at the sitter who he was convinced was employed by his former company to keep him entrapped. “Diane!” he yelled, his voice ripped with anger. “How are you doing, Mark?” I asked calmly. “I’M BEING KEPT HERE BY THIS IDIOT RPCO JERK,” he yelled, pointing at the quiet young woman sitting in a chair. RPCO was a department at Bettis that he worked in. “Can I let him out?” I asked the sitter. She said yes. I unzipped the side of the bed tent. He was naked because he was refusing to wear hospital clothes. The sitter and I helped him get into street clothes I had brought, all the while with him protesting our help. I could see that his leg drains were still intact, thankfully. Overnight, he had pulled out the top four staples from his neck. There’s nine more still in place.

Within a couple minutes, the occupational therapist, accompanied by two support people, arrived for Mark’s first therapy of the day. He was having none of it.

“What’s your name?” the OT asked him.

“COULD BE ANYTHING FROM ADAM TO ZACHARIAH!” he yelled back.

“Okay,” she said calmly. “Who is this with you?” she pointed at me.

“COULD BE ANYONE FROM ALICE TO ZEPHARELDA!”

“How many kids do you have,” she tried.

“COULD BE ANYTHING FROM 0 TO 500!” he roared.

I looked at the OT. This is a new one, I said, bewildered. He’s never done these extremes.

He did an excellent job of continuing to refuse treatment by creatively using words that began with an A and a Z. The sitter’s name could have been Aardvark or Zebra. The road we live on could be Annapolis or Zelopolopolis. “Drive,” he added to that one after a beat.

He did the same routine with speech therapy.

By the time PT came in, he had worn himself out enough that while still being belligerent, he at least complied with taking a walk. This took three staff people: two PTs on either side, and the sitter following right behind with a wheelchair in case Mark collapsed. I trailed along to watch. Mark is basically relearning how to walk.

After the therapies, I asked Mark if he wanted to look out his window with me. He paddled his wheelchair over. Mercy Hospital sits high on a hill. Mark’s corner room faces east/southeast and has a spectacular view of the Mon River, the Southside Flats and the Southside Slopes. There’s a lot to watch. Road traffic, coal barges, and kayakers. Freight trains and plane contrails. The mountainside is lush, the bridges are beautiful. If it was a hotel room, it would be thrilling.

We talked about the things we were seeing. We talked about Kennywood. He persisted in thinking he was being trapped at work, and specifically in a two year placement in Newport News, Virginia, which he really had taken in the early 2000’s. He kept asking me who was in the office. He referred to the rehab staff as “upper level administration.” I’m writing this on Sunday morning, and Mark still thinks I’m commuting five hours back and forth from Pittsburgh everyday to see him. It took me a whole day to figure out that part of his confusion about where he is is that the second window in his room overlooks construction of a new hospital building. He thinks it’s the shipyard. He points out where new fuel cell equipment is being built. Sometimes, if it feels like he is not as agitated, I remind him we are in Pittsburgh in a rehab hospital. “I keep getting confused,” he says. It’s okay, I reply. You’ll get better.

And then without warning, he will switch back to the shipyard. Back to agitation. “Where are my shoes?! Give me my shoes! These idiots are keeping them from me!”

This is the nature of Mark’s frontal lobe injury. His personality swings, he is impulsive, he is not himself. And then he is. And then again gone. He’s refusing to take meds from the nurse, because “I’m not taking anything from Newport News!” I can calmly say, hey Mark, it’s time for me to give you your meds. He will take them from me. Sometimes only after I verify that I did not get the meds from Newport News.

It’s all very disturbing, and I mean to him and to me. I can see, in his state, how he is feeling like he’s been tricked. Why he feels trapped. He is constantly being watched. He is being given tests and he can’t fully understand why or the results. He is in a locked unit and cannot get out.

At the heart of it, he is deeply confused. He is deeply afraid. And he just wants to go home.

I have no news on when that will be. The rehab staff are still getting to know him and working on a treatment plan. Everyday I go in not knowing what it will be like. I am not confused. I am a little afraid. And I am deeply exhausted.