I lifted the metal lid to discover that the plate of food had three mounds on it. I scooped a spoonful from the green pile and lifted it toward his mouth as he deliberately turned his head away from me. I then made a split second decision – a risky one:
Glancing around in hopes that none of my co-workers could hear me, I whispered, “Hmmmm this smells a little like cat food to me.”
He laughed out loud but I don’t think he wanted to.
“Have you ever tasted cat food before?” I teased.
He turned to me, made eye contact, grinned and then opened his mouth to accept a spoon filled with mashed peas. That was the first day I met Mr. Andrew Michael Johnson, Jr. – the new patient in the middle bed in room 69.
Three hours earlier at the three o’clock shift change report, I was briefed about this newest addition to the ninety-nine patients who resided in the Chippewa Lake Nursing Home - a sixty-two year old male. His name is Andrew Michael Johnson, Jr., but he preferred to be called Mike - “an uncooperative, Aphasic, Cerebral Vascular Accident (CVA) patient with a Right Hemi Paresis and Dysphasia,” the day nurse read aloud from the gray metal spring-loaded chart. “He is a farmer who didn’t come in for supper one night. His wife found him in the barn, unconscious.” He had suffered a stroke, specifically a blocked vein that burst open and bled into the left side of his brain, and as a result he woke up unable to walk, use his right arm, swallow properly or talk.
“The hospital therapists determined he was a candidate for rehab, but he refused to cooperate and they closed his case,” She concluded and then added that reportedly, he’d kicked at a nurse while still in the hospital earlier in the day. Mike was described as very angry, stubborn and uncooperative.
“Be careful around this one,” she warned.
“Okay.” I acknowledged.
His name was added to my roster for the afternoon shift that was to end thirty minutes before midnight.
I entered his room to introduce myself and observed that he would not look at me. In fact, he totally ignored me. No mention was made of him being hard of hearing, so I proceeded as if he was hearing my every word. Some stroke patients who lose their ability to speak are also unable to understand or interpret words spoken to them. I then accidentally tripped over my own feet. Catching my balance, I noticed a smirk form on his face and a small involuntary snort of air blew out his nose. Unintentionally I had discovered that he was aware of all that was going on - visually speaking, at least.
I quipped, “Yesterday I ripped the seat of my pants open when I slipped on a puddle of pee in the hall.”
He laughed out loud. Aha, he did understand. My silly little impromptu joke worked. Perhaps this Mike character could be distracted from his world of anger after all, I thought to myself.
A couple of hours later, the meal trays had arrived in the Two-East wing. I looked for Mike’s specifically because I wanted to be the one to feed him. No Added Salt – No Thin Liquids - Ground Solids.
As I carried the supper tray over to his wheelchair I asked, “Mr. Johnson, are you hungry, sir?”
No eye contact. No response.
I sat down next to him and uncovered a plate of three ice-cream scoop sized piles of brown meat, green vegetables and white mashed potatoes. Mike had swallowing problems so his food had to be ground to help avoid choking as it passed through his partially paralyzed throat. That condition confirmed his inability to speak, as well. Coaxing him to eat, I learned that humor was an attention getter with Mike, my new-found buddy in 69B.
Mike continued to be very stubborn and took his anger out on those who tried to help him. This can be typical of people who suddenly wake up disabled; every task performed for him by someone else was a reminder of his sudden acute losses. I could make him laugh and I could get a smile out of him. In his stubbornness he would often try not to laugh at my attempts to humor him, but since the part of his brain that is the keeper of emotions was damaged by the stroke, he had little control over them. He’d shake his head and roll his eyes at my silliness. As the months passed, Mike began communicating with me more and more. He remained silent and would clumsily make gestures with his left, only functional, arm. He would make and maintain eye contact and at times we communicated only through our eyes. His look could encourage me to continue or warn me to stop. He would attempt to take a few steps with me and an ankle brace supporting him – something he refused to do with my peers. Many days he refused to eat unless I was the attendant feeding him. He would only allow me to be the one who gave him a shower. An Occupational Therapist brought a communication board into his room – a patient can simply point to a picture or phrase to indicate what he needs. Mike would have no part of it. In fact, he threw it across the room. But, he had me, with whom he chose to communicate. I think he trusted me to be genuine.
I learned from his wife, Gladys, that they had married young and that he and his new bride moved in with his parents on the family farm. Shortly thereafter, his father passed away and he became the primary breadwinner. Over the years they had a daughter and a son of their own who had each grown up, married and moved several miles away. Like me, neither child was interested in keeping the farm in the family. Mike worked hard farming the land and milking Guernsey cows. He didn’t have a lot of free time, but when he did, he enjoyed driving around the countryside exploring back roads in the part of the county known as the Red Hills. At the time of his stroke, he owned a brand-new pickup truck. “It was his pride and joy,”. Gladys sighed, fighting back tears. Gladys sold the herd to help pay the pickup off and eventually took a job at the Onion-Ring Factory. She would visit Mike for a few minutes several days a week after a tedious shift spent sorting out bad onions from the good ones on a conveyor belt. She would drive his cherished truck up Main Street still donned in her soiled white apron, black hair net and skin reeking of onions. She’d say good night to her husband before heading home, exhausted. Gladys ruefully confided that Mike was angry with her because she sold his cattle and took a job at the factory. Knowing how much he loved riding through the country she wished that she could afford to trade his beloved pickup-truck in for a car because she couldn’t possibly get him in and out of the truck’s high cab. But she also knew selling his truck would be another devastating blow. She said that she even contemplated selling the farm but again was afraid of his reaction.
“It would kill him. The farm has been in his family for three generations,” she choked.
I attempted to console her saying, “I don’t think he is angry at you, I think it is the circumstances.”
“I’m not so sure. Not so sure...I never got along well with his mother who became very difficult in her old age. I used to say we should sell the farm and put her in a home,” she sobbed, “Now I’ve put him in a home.”
Apparently, Mike had gone deeply in debt building an expensive, state-of-the-art silo and buying his dream-come-true midnight blue Chevrolet. The meager rent Gladys received from renting out the fields, barn and silo to a neighbor barely made the loan payments. I am convinced that he felt guilty putting her in a financial bind. Mike had a lot to feel frustrated and angry about; and to feel guilty about too.
When winter was clearly over and the days began to warm, I made the necessary arrangements to take Mike for a joy-ride, in my car. The Director of Nursing Services was reluctant to go along with my plan, giving me a lecture on professionalism and warning me of the risks.
“I wouldn’t advise it – it isn’t professional to become too friendly with patients - they start expecting preferential treatment. But you are off duty y’know. If anything happens, it is your responsibility. But, I also can’t tell you that you cannot do this.” She cautioned.
Mike sobbed non-stop the first few minutes of our drive. Then he began moaning and clumsily pointing with his left arm showing me where to turn. We were driving in the country when he suddenly pointed and mumbled quite clearly, “farm” and then immediately burst into tears. He had taken me to his farm. That was the first of many trips and adventures we would take with Mike navigating – he was my back-roads GPS. Eventually Gladys planned a family reunion at the farm. “I’ll pay you to escort him - what do you think?”
“I think it is a great idea. You don’t need to pay me.”
His son and I carried his wheelchair up the steps into the screen-porch and rolled him through the kitchen door. Tears streaming down his face, Mike was home.
Mike detested life in the nursing home. He refused to participate in any therapy modalities or activity programs. However, secretly, in the early afternoon before I came on duty, he would agree to go to the recreation studio where he built a bird-house from a kit using his awkward non-dominant left hand and a vice to hold the wood in place. Later the activity therapist told me of his frustration and outbursts of anger while attempting to complete the project. After sanding, staining and gluing it together, he sobbingly presented the birdhouse to me. Mike had made a gift. A gift for me.
He continued to refuse to use a communication board, but he would clumsily write messages in the air with his left arm. I was the sole person with whom he chose to communicate. When I would finally get something figured out, his emotions would get the best of him. It is amazing how well we communicated without him uttering a word. He had a life-long friend named Joe, who would occasionally come to visit. One day, being a bit forceful with him, I was attempting to get Mike to say the name Joe. Typically, he kept refusing to try and he was growing angry with me for pushing him to do so.
Finally I said, “Listen Mike, I know you can do it, tell me who your best friend is.”
He turned, looked me in the eyes as his filled with tears, and as clearly as I ever heard anyone speak, he responded, “You.”
Glancing around in hopes that none of my co-workers could hear me, I whispered, “Hmmmm this smells a little like cat food to me.”
He laughed out loud but I don’t think he wanted to.
“Have you ever tasted cat food before?” I teased.
He turned to me, made eye contact, grinned and then opened his mouth to accept a spoon filled with mashed peas. That was the first day I met Mr. Andrew Michael Johnson, Jr. – the new patient in the middle bed in room 69.
Three hours earlier at the three o’clock shift change report, I was briefed about this newest addition to the ninety-nine patients who resided in the Chippewa Lake Nursing Home - a sixty-two year old male. His name is Andrew Michael Johnson, Jr., but he preferred to be called Mike - “an uncooperative, Aphasic, Cerebral Vascular Accident (CVA) patient with a Right Hemi Paresis and Dysphasia,” the day nurse read aloud from the gray metal spring-loaded chart. “He is a farmer who didn’t come in for supper one night. His wife found him in the barn, unconscious.” He had suffered a stroke, specifically a blocked vein that burst open and bled into the left side of his brain, and as a result he woke up unable to walk, use his right arm, swallow properly or talk.
“The hospital therapists determined he was a candidate for rehab, but he refused to cooperate and they closed his case,” She concluded and then added that reportedly, he’d kicked at a nurse while still in the hospital earlier in the day. Mike was described as very angry, stubborn and uncooperative.
“Be careful around this one,” she warned.
“Okay.” I acknowledged.
His name was added to my roster for the afternoon shift that was to end thirty minutes before midnight.
I entered his room to introduce myself and observed that he would not look at me. In fact, he totally ignored me. No mention was made of him being hard of hearing, so I proceeded as if he was hearing my every word. Some stroke patients who lose their ability to speak are also unable to understand or interpret words spoken to them. I then accidentally tripped over my own feet. Catching my balance, I noticed a smirk form on his face and a small involuntary snort of air blew out his nose. Unintentionally I had discovered that he was aware of all that was going on - visually speaking, at least.
I quipped, “Yesterday I ripped the seat of my pants open when I slipped on a puddle of pee in the hall.”
He laughed out loud. Aha, he did understand. My silly little impromptu joke worked. Perhaps this Mike character could be distracted from his world of anger after all, I thought to myself.
A couple of hours later, the meal trays had arrived in the Two-East wing. I looked for Mike’s specifically because I wanted to be the one to feed him. No Added Salt – No Thin Liquids - Ground Solids.
As I carried the supper tray over to his wheelchair I asked, “Mr. Johnson, are you hungry, sir?”
No eye contact. No response.
I sat down next to him and uncovered a plate of three ice-cream scoop sized piles of brown meat, green vegetables and white mashed potatoes. Mike had swallowing problems so his food had to be ground to help avoid choking as it passed through his partially paralyzed throat. That condition confirmed his inability to speak, as well. Coaxing him to eat, I learned that humor was an attention getter with Mike, my new-found buddy in 69B.
Mike continued to be very stubborn and took his anger out on those who tried to help him. This can be typical of people who suddenly wake up disabled; every task performed for him by someone else was a reminder of his sudden acute losses. I could make him laugh and I could get a smile out of him. In his stubbornness he would often try not to laugh at my attempts to humor him, but since the part of his brain that is the keeper of emotions was damaged by the stroke, he had little control over them. He’d shake his head and roll his eyes at my silliness. As the months passed, Mike began communicating with me more and more. He remained silent and would clumsily make gestures with his left, only functional, arm. He would make and maintain eye contact and at times we communicated only through our eyes. His look could encourage me to continue or warn me to stop. He would attempt to take a few steps with me and an ankle brace supporting him – something he refused to do with my peers. Many days he refused to eat unless I was the attendant feeding him. He would only allow me to be the one who gave him a shower. An Occupational Therapist brought a communication board into his room – a patient can simply point to a picture or phrase to indicate what he needs. Mike would have no part of it. In fact, he threw it across the room. But, he had me, with whom he chose to communicate. I think he trusted me to be genuine.
I learned from his wife, Gladys, that they had married young and that he and his new bride moved in with his parents on the family farm. Shortly thereafter, his father passed away and he became the primary breadwinner. Over the years they had a daughter and a son of their own who had each grown up, married and moved several miles away. Like me, neither child was interested in keeping the farm in the family. Mike worked hard farming the land and milking Guernsey cows. He didn’t have a lot of free time, but when he did, he enjoyed driving around the countryside exploring back roads in the part of the county known as the Red Hills. At the time of his stroke, he owned a brand-new pickup truck. “It was his pride and joy,”. Gladys sighed, fighting back tears. Gladys sold the herd to help pay the pickup off and eventually took a job at the Onion-Ring Factory. She would visit Mike for a few minutes several days a week after a tedious shift spent sorting out bad onions from the good ones on a conveyor belt. She would drive his cherished truck up Main Street still donned in her soiled white apron, black hair net and skin reeking of onions. She’d say good night to her husband before heading home, exhausted. Gladys ruefully confided that Mike was angry with her because she sold his cattle and took a job at the factory. Knowing how much he loved riding through the country she wished that she could afford to trade his beloved pickup-truck in for a car because she couldn’t possibly get him in and out of the truck’s high cab. But she also knew selling his truck would be another devastating blow. She said that she even contemplated selling the farm but again was afraid of his reaction.
“It would kill him. The farm has been in his family for three generations,” she choked.
I attempted to console her saying, “I don’t think he is angry at you, I think it is the circumstances.”
“I’m not so sure. Not so sure...I never got along well with his mother who became very difficult in her old age. I used to say we should sell the farm and put her in a home,” she sobbed, “Now I’ve put him in a home.”
Apparently, Mike had gone deeply in debt building an expensive, state-of-the-art silo and buying his dream-come-true midnight blue Chevrolet. The meager rent Gladys received from renting out the fields, barn and silo to a neighbor barely made the loan payments. I am convinced that he felt guilty putting her in a financial bind. Mike had a lot to feel frustrated and angry about; and to feel guilty about too.
When winter was clearly over and the days began to warm, I made the necessary arrangements to take Mike for a joy-ride, in my car. The Director of Nursing Services was reluctant to go along with my plan, giving me a lecture on professionalism and warning me of the risks.
“I wouldn’t advise it – it isn’t professional to become too friendly with patients - they start expecting preferential treatment. But you are off duty y’know. If anything happens, it is your responsibility. But, I also can’t tell you that you cannot do this.” She cautioned.
Mike sobbed non-stop the first few minutes of our drive. Then he began moaning and clumsily pointing with his left arm showing me where to turn. We were driving in the country when he suddenly pointed and mumbled quite clearly, “farm” and then immediately burst into tears. He had taken me to his farm. That was the first of many trips and adventures we would take with Mike navigating – he was my back-roads GPS. Eventually Gladys planned a family reunion at the farm. “I’ll pay you to escort him - what do you think?”
“I think it is a great idea. You don’t need to pay me.”
His son and I carried his wheelchair up the steps into the screen-porch and rolled him through the kitchen door. Tears streaming down his face, Mike was home.
Mike detested life in the nursing home. He refused to participate in any therapy modalities or activity programs. However, secretly, in the early afternoon before I came on duty, he would agree to go to the recreation studio where he built a bird-house from a kit using his awkward non-dominant left hand and a vice to hold the wood in place. Later the activity therapist told me of his frustration and outbursts of anger while attempting to complete the project. After sanding, staining and gluing it together, he sobbingly presented the birdhouse to me. Mike had made a gift. A gift for me.
He continued to refuse to use a communication board, but he would clumsily write messages in the air with his left arm. I was the sole person with whom he chose to communicate. When I would finally get something figured out, his emotions would get the best of him. It is amazing how well we communicated without him uttering a word. He had a life-long friend named Joe, who would occasionally come to visit. One day, being a bit forceful with him, I was attempting to get Mike to say the name Joe. Typically, he kept refusing to try and he was growing angry with me for pushing him to do so.
Finally I said, “Listen Mike, I know you can do it, tell me who your best friend is.”
He turned, looked me in the eyes as his filled with tears, and as clearly as I ever heard anyone speak, he responded, “You.”
“Be devoted to one another in love. Honor one another above yourselves.” Romans 12:10 “And Jonathan made a covenant with David because he loved him as himself.” I Samuel 18:3
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