Dad Rehab
He had to come back from near catastrophe, and recovering from a stroke was only part of it.

By Pamela Gerhardt
Sunday, June 8, 2008

WE ARE ON A MISSION. My sister and I scurry like church ladies setting out an Easter buffet. We remembered to get plastic knives and forks, the napkins. Lots of napkins. He will need them. We arrange the takeout containers of moussaka, the gyro, the large Greek salad, the three pieces of baklava.

We rub our palms over the synthetic fabric of the tablecloth, smoothing the wrinkles.

"Okay," my sister Barb says. "Go get him."

In his room at the skilled nursing facility in South Carolina, I find my dad where we left him: flat on his back on a hospital bed. "Ready?" I ask.

I get the wheelchair out of his bathroom. I lock in the foot pieces but remember to keep them swung out, so he won't trip as he gets into the chair. I fold down his metal bedrail. I swing his legs and hips closer to the edge of the bed. He lifts his head, and I reach around and place my palm at the center of his upper back, between the shoulder blades. I bend my knees for support, as if ready to lift a piano. My dad is not a big man: narrow shoulders, 5-11, about 165 pounds. Still, the left side of his body is about 70 percent paralyzed from the right-brain stroke, and I'm prepping to move dead weight. As I reach around his back, our faces are abnormally close. Our eyes meet, and we burst into laughter, me hunched over, knees bent, with my rear in the air, he trying to lean on his one good elbow. "No laughing," I say.

"You started it," he says.

"Ready?" I ask. "On three. One, two . . ."

And up he goes. He's standing. We pivot. We dance. His hands are on my shoulders. Mine are on his hips. The goal is to make the left leg and foot move, to inch around until he feels the wheelchair seat at the back of his legs. Left foot. Right foot. Left foot. We say these words out loud together. He starts to bend his knees, as if to sit. "Dad, don't bend your knees until you feel the chair, or you'll land on the floor."

No answer.

"Dad, do you feel the chair?"

"Yes."

"Then bend."

"I am."

He's in. I am surprised to find that I have broken into a slight sweat. I am aware of my thumping heart.

The next part is easy. A series of clicks. I am with purpose, a fine-tuned machine, a humming factory. Swing the chair's feet around. Click. Lift his legs into the feet. Fasten his seat belt. Click. Get the padded armrest out of the closet and slide it onto the chair. Click. Adjust his paralyzed arm on the armrest. Unlock the brakes with a swift flip of my foot. Click. Click. Out we go into the corridor.

The hallway floor is lined with navy-and-burgundy carpet, richly printed in a mock Persian pattern. It's the first thing you notice. The place is nice. Beige-and-blue floral wallpaper. Gold sconces lining the walls. Not my family's taste, but pleasing enough. What the heck. The facility is by far the best we could find.

A month earlier, my sister and I had checked out six long-term rehabilitation facilities all over the city. A whole morning in and out of the car with my 6-year-old daughter in the back seat, holding a pink purse full of crayons. We found rooms packed with people in wheelchairs, their heads sagging to their chests, parked in front of the Cartoon Network blaring from TVs.

The dementia element bothered us, but right away we knew we were up against a force far more menacing than nursing home cliches: the female problem.

These places are operated by women and, mostly, stocked with women. We were overwhelmed by doilies, potpourri, stuffed bunnies and bears with bows, caged finches, church services, vases of paper poppies, beauty parlors featuring "manicure afternoons." I was reminded of my son's experiences with elementary schools, also organized and run by women, where teachers ask 7-year-old boys to sit at desks all day and read books about ponies. My sister and I consulted each place's activity calendar. Where was poker night? Movie night featuring "Saving Private Ryan" or "Master and Commander"?

Where was the bar?

In an earlier, acute, short-term rehab place, my dad entered the rehab room cluttered with exercise bikes, parallel bars, walkers -- an arsenal of tools to battle stroke-induced paralysis and brittle, broken hips. He looked around. "All women."

I nodded. "The men are all dead, Dad. You're the Omega Man. Charleton Heston." I added, "Someone needs to open a national chain of men-only rehab places."

He added, "They could hang up posters of beautiful women in the rehab room. Now, that would be motivating."

One of my friends heard about this idea of men-only rehab and said, "You could call it He-hab."

I roll my dad down the hall. A serious abstract painter with an MFA and the subject of many one-man shows, my dad really takes issue with the bad art on the walls of institutions -- bright pink sunsets over aquamarine oceans. Early into the Stroke Adventure, my brothers and sister and I began to mimic him from behind the wheelchair. We would point to the paintings as we passed. "See that? Crap."

Lost in Translation

"THIS GYRO DOESN'T TASTE LIKE LAMB," my dad says. He's 80 and has lived a varied life. He sweated it out and learned to smoke cigarettes on Guam in the months following World War II; helped raise five children; traveled across the country as a salesman; whiled away evenings jamming on acoustic instruments with his friends and family; went back to college at age 40; became a high school art teacher; traveled to Europe many times; nursed my mom through cancer until her early death; then moved from St. Louis, our home town, to South Carolina and began a new life.

But he's never had a gyro.

My 18-year-old nephew told him a few days earlier about the good Greek restaurant down the street. "I could pick up takeout," my nephew suggested. My dad insisted he wanted the gyro, rather than, say, a lamb kebab. He talked about it for days. Now, he can't understand why the gyro doesn't taste like the roasted lamb he was expecting. Somewhere, somehow the message got garbled.

That definitely happens a lot here.

At a table a few feet away, a woman with a neatly coiffed platinum blond bob set off by a navy- and white-polka-dotted silk scarf around her neck, lifts her fork to her face with precision and grace, hinting at a previous life of privilege. The fork and food land squarely on her cheek.

It's a wonder anyone maintains weight here. I force down a bite of moussaka.

"Is this white stuff mayonnaise?" my dad asks and pokes with his one good hand at the gyro, which by now is so mangled you wouldn't recognize it. Food and liquids dribble out of the paralyzed left half of his lower lip, which is deflated, loose, like a rubber baby pool that has sat on the lawn well into autumn.

"Yogurt," I answer. Barb, seated across from me, smiles and rolls her eyes. I lift the lid of one of the large containers and note the giant mound of iceberg, olives, feta.

"There's way too much salad," I announce.

When caring for the sick, we go overboard, buy too much of everything, as if grand-scale purchases might undo things.

Welcome to Las Vegas

I WAS FLOATING. I WAS IN THE CLOUDS.

It was a month before that Greek buffet in South Carolina, and outside the airplane window, the Nevada dessert unfolded in ripples of brown. I thought: peanut butter. It looked like peanut butter, spread by God's spatula.

I was flying to visit my dad, a man I hadn't seen in seven years, in an intensive care unit. Maybe he was dying. Maybe not. I was calm. I was wearing my brave face, one that I recognized from previous times in my life, like in 1983, when I left Missouri for good at age 22 and drove my Subaru hatchback to New York City to look for a job and start life. I was vacant. I was Scarlett O'Hara. I would think about it all tomorrow.

The last time I had seen my dad, he was drunk, passed out on the wooden floor planks of his back porch on Christmas Eve in South Carolina. Afterward, I returned to my home in University Park and wrote him a letter: Please stop bingeing like that. You are at your best when you are sober.

With the exception of two cryptic -- and I do mean cryptic -- phone calls, that had been the last time we had communicated.

I was calm. I was surrounded by revelers pumped up with the prospect of fortune on their way to Vegas. I might have been the only person on the plane with a different kind of agenda.

What that was, I was not entirely sure.

The pilot, clearly enamored of the role of cruise director, announced sites along the way -- The Rocky Mountains! The Grand Canyon! -- and our final destination with the enthusiasm of a carnival barker. "Buckle up and sit back. We're on our way to Laaaas Vegaaaas!" he said several times during the flight. The cabin erupted in cheer.

Three days earlier, I had been having a yard sale when the phone call came. A customer wanted to buy our futon and frame, which was sitting in the front yard, the clean, canary-yellow mattress cover looking perky and inviting against the brilliant green of the spring lawn. I would have bought it, too. My kids were selling lemonade and brownies.

The customer needed change. In the kitchen, I saw the message light blinking on the answering machine.

I listened to four messages from my various siblings: There's been an emergency out in Arizona -- our dad has had a stroke. Arizona? I went back outside and completed the transaction with the customer. I helped him get the futon into his truck. I sold a few more things to customers. I did not call back my siblings until late afternoon.

It turned out that one of my brothers, Joe, had been on vacation with our dad in Nevada and Arizona. Joe had never seen the Grand Canyon, and Dad had wanted to see it for a third time. Off they went without telling anyone -- which was not unusual in our family.

It turned out that Dad had had a "mini" stroke a few months earlier and hadn't told anyone -- not even his doctor. Instead, he had arranged the Grand Canyon trip.

That day in Arizona, our dad had been sick with diarrhea. Food poisoning, they thought. Joe had given him Gatorade, Pepto-Bismol.

That evening, unable to sleep in the same hotel room with our snoring father, Joe had requested an adjacent room, then changed his mind and moved to a room even farther away, on a different floor. This decision would haunt him for many weeks.

The next morning, Joe called Dad, an early riser, on the phone. No answer. He called again. He walked over to Dad's room and banged on the door. No answer. He walked around the hotel. Called again. Knocked again. Finally, he got the manager to open the door with a master key. There, naked, on the floor, was our father, incoherent and unable to move.

At the emergency room in Page, Ariz., Joe wept in front of the attending physician, saying it was his fault. No, said the doctor, you couldn't have done anything to change this outcome. Dad's left carotid artery was 90 percent blocked. The other was 70 percent blocked. These arteries are the main source of blood to the brain.

At the Page community hospital, Joe and Dad waited for a bed at a larger hospital in Phoenix. Barb had booked a flight to Phoenix and was on her way to help out. On the phone, I encouraged my brother to step out and get something to eat. When he got back, our dad was not there. "We're putting him on a helicopter to a hospital in Vegas," a staff member told him. "It's the only hospital in the area with an open bed. They're taking off now." My brother called my sister, who was boarding her plane to Phoenix, walking through the gate. "Don't come to Phoenix!" he yelled. "We're going to Las Vegas." She changed her flight plans. Joe got into a rental car and drove five hours through the desert in the middle of the night to Vegas, his radio blaring, a map at his side. He found the hospital as the sun rose. Barb arrived that morning.

They stayed two more days. And then they needed to get back to work. Our father was still in the ICU.

"Someone needs to be here," Joe told me on the phone. My other brother could not leave his hourly construction job. Our other sister is disabled. "It has to be you."

As a university instructor, I was on break. It made sense. I should be the one. Strictly practical.

"The case manager here says he'll be fine until you get here," Joe said. "He's in good hands. It's an ICU, for chrissakes."

Over the years, I had been careful to send Christmas cards, birthday cards to my father. No response. "I don't think he will let me in the room," I told my brother.

"I already told him you will be the one, and he said, 'Fine,'?" my brother said. "The staff here knows you're coming. He knows you're coming."

In the end, I had told my brother and sister I would go. "But I'm doing this for you."

Rewriting the Past

I WAS IN THE CLOUDS, wondering about the truth behind that statement, not knowing that during the lousy seven-hour journey via Minneapolis our father had been moved from the ICU to a rehab facility a few miles down the road, where the staff would leave him outside in the desert climate to smoke and "get some fresh air." After five hours, he would be rushed back to the emergency room with severe sunstroke and dehydration, and a fever of 107 degrees; a doctor would pack ice into his armpits and his crotch and say, "Sorry, buddy. But I'm trying to save your life."

My plane landed at 8:57 p.m. Final strips of the day's pink light streaked the sky. I got the rental car, found the highway. I decided to drive straight to the hospital. Get it over with. Face the dragon.

I spotted the blue glow of the neon hospital name at the top of the building from the highway. I stopped at a gas station and bought cigarettes. I smoked one. In the hospital parking lot, I smoked another. I had no idea where Dad was, so I went into the emergency room. Workers there directed me to the ICU. I got lost. Asked again for directions.

Finally, I arrived at a set of double doors. Locked. A phone to the right with a sign read: "Dial 20." I did this. "I'm here to see Ernie Gerhardt." Saying his name suddenly cut through the dreaminess of the flight and the fairyland dancing neon of the Vegas skyline that I had glimpsed from the highway. His name. He was, after all, my father.

The door buzzed, and I pulled it open. The nurse pointed me to the room. I walked toward it. At the doorway I paused. The room was dark and hazy blue and silent, except for the soft beeps of life support machinery on the ward. There he was, with his eyes closed, lying in the bed. I was glad he appeared to be sleeping; it gave me a few minutes. His face seemed more handsome than I remembered, with a sharper nose. I slowly approached his bed. Too soon, he opened his eyes. This would be it.

"It's me, Pam."

"Barb?" he asked. The stroke had left him temporarily blind in the left eye.

"No. It's Pam. Barb is gone."

"You're Pam?"

"Yes," I answered. And then I was crying. Squeaking out my words like a child who had just bumped her head. "It's me."

"How are you?"

I could barely speak. I nodded. "How are you?"

"I never thought I'd have a stroke in Arizona," he said, then slowly added, "You're in the same hotel she stayed in? It's a good deal, a good price."

I thought, good, he is lucid. And he is the same, thinking about the practical matters. But then I thought that perhaps he had rehearsed this, wanting to start with something concrete and mundane.

He dozed in and out. I sat in the chair to the side of his bed, which the nurses had jacked up high, I guessed to avoid straining their backs to move him. After a few minutes, he said, "Come closer."

I stood again and took his hand.

"That letter you wrote," he began to say, and I interrupted him.

"It was a mistake."

"You had a right to write it. It was very angry. You were angry. But then you should have rewritten it. It might have been only four sentences long. You could have said it all in four sentences."

"I should have written it and ripped it up."

He said, "You have an MFA in writing. I have an MFA in art. You know how to do it."

I realized he was talking about editing. Audience. Rhetorical situations. "You didn't need to talk about my painting. That really hurt me," he said, referring to a sentence in the letter where I suggested that his work was best when he was not bingeing. He added: "And I should not have gotten so drunk. I was wrong."

The Great Escape

AFTER THE GREEK DINNER, my sister and I clean up the mess and get my father back to his room and into bed. We tell him he has several weeks of rehab in the skilled nursing facility, then we hope to get him home.

"Think you can get through the next few weeks?" I ask.

"I think I can do that."

"Will it be hard?"

"I got the clock, the calendar. I'll just sit here like Burt Lancaster on Alcatraz and mark off the days."

"You can carve notches in the wall."

"I stashed a fork and a spoon under my mattress. Tomorrow, I start digging in the bathroom."

"A tunnel," I offer.

"I'll throw the dirt outside the window. But when it gets up to the sill, they'll know."

My sister gets ready to leave, but we realize we have not positioned him correctly. He's too low down on the bed. His feet are pushed against the footboard. She stands on one side of the bed. I stand on the other. We must move him by simultaneously lifting the pad beneath him. We have done this before. Dad, on his back, looks at the ceiling. I can see in his eyes -- which are a brighter blue, more youthful, since the stroke -- that he is going to make a joke. We ignore him. We are pros. I announce, "On three." We pause, ready for action, but I sense an unraveling. "One, two . . ."

My sister bursts into laughter.

We never get to three, but move him anyway. Out of sync. It's a disaster. Barb is doubled over with laughter. Dad is chuckling. He's cockeyed on the bed, his head hanging over the edge.

"You have to wait until we get to three," I manage to say to my sister.

"I see a bright light," Dad says, lying there cockeyed. "And my dead parents, waving in the distance. And poor Buddy, the dog."

On the Cusp

I STAY AWHILE AFTER MY SISTER LEAVES.

"Are you worried about anything?" I ask. "Got anything you want to tell me?" I'm in the chair next to his bed. He's watching the Food Network. We are lighthearted. Grateful to be sitting here, doing our thing. I think it reminds us both of a time 20 years earlier, right after Mom died, when he was living as a bachelor in Surfside Beach, S.C., and I was a VISTA volunteer in nearby Charleston. We saw each other often, visited sunlit art galleries, devoured fresh seafood at restaurant tables surrounded by swaying palmetto trees. We were thin, tan transplants from a decaying city in the Midwest. We were migrants from the dark. We were survivors of a great loss.

"Anything on your mind?" I ask again.

"Yeah. I'm thinking about how I'm going to live, how I'm going to get the mail when I'm back at home."

I nod.

"I'm thinking about some kind of scooter."

"Like the kind at grocery stores?"

"Not exactly. I'll get a piece of plywood and put four roller-skate wheels underneath it."

"Like in 'The Great Escape.'?"

"Yeah," he says. His eyes light up. "I'll fashion a pulley system down the driveway, pull myself along a rope."

His roommate wheels himself into the room, looks for something in the bathroom, then leaves. The roommate has been driving my dad nuts. In his previous life, the man had worked as some sort of university library administrator. We can't figure it out. He "designed" libraries "all over the world."

"All over the world," Dad says, waving his one good hand dismissively. "The man mentions this to anyone who walks into the room, several times an hour. All over the world. What the hell kind of person talks about their achievements that much? What if I went around talking about how I was a great regional painter, famous in the central Atlantic region?"

"An artist on the cusp of being discovered," I say.

"Right. On the cusp."

I reach into my backpack and begin to fumble through a stack of white papers. Dad is flipping between a cooking and a travel show.

"What are you doing over there?" he asks. "What is all that?"

"I'm grading papers."

He lifts his head for a better view. "They're typed?"

"All typed."

His face saddens. "That's terrible." I think he might cry. He rests his head on the pillow. "Cursive writing was such a beautiful way to correspond."

"No one writes in cursive anymore, Dad."

He thinks about this. "That's terrible."

On the TV, Emeril is showing us how to make chicken a la king. "Oooh, that looks good," I say.

"I thought you were grading," he says.

"I'm multitasking, Dad."

"Right," he says, a man flat on his back in diapers, with an ice pack on his shoulder and a yellow blanket, as soft as a baby's, draped across his partially paralyzed leg, and with a left hand purple, swollen and useless for the remaining years of his life. "And I'm on the cusp."

Later, as I am driving along an empty South Carolina highway, I think about the word cusp: the singular point of a curve. Life has not been a circle at all, for us, but a series of curves. We stray apart. We intersect. The roping of a DNA chain. The smallest gesture -- one drink, one word too many -- catapults us in opposite directions. I did not think -- who could? -- that we would come together again in the soft blue light of an intensive care unit in a hospital in Las Vegas. As the sun sets behind the loblolly pines that line the highway, I know this: We are glad to be in each other's company. We are lucky.

Ernie Gerhardt died in April. Pamela Gerhardt, who teaches narrative nonfiction at the University of Maryland, is writing a memoir about her father's stroke. She can be reached at gerhardt@umd.edu.