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Old 03-14-2010, 01:15 AM
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Default Cara and the Cabman by HoiLei

I hear the click of a cane and know Cara is here. Not even 50 yet, she's too young to have this much trouble walking. But there's no such thing as "too young" in this world. Several years post-stroke, Cara also has trouble talking. She comes into our aphasia clinic to help us in a research study we're doing. I work with her several times a week, showing her dozens of pictures, one after another, and recording her answers. Then we try different therapy methods to see which works best. It's hard work for her.

I show her a cat and she looks at it while working her throat to say something. "S-- ssssss-- Oh, my god."

"It's okay," I answer and go to the next picture. An apple.

She lights up: "I know that one. Oh, my God, I love them. It's a--" A minute later, she shakes her head and I go on. Sometimes she gets a word, and this delights her, but most of the time she can't say anything and she droops lower with each trial. I try to encourage her, bolster her spirits. We may talk a bit about an item, but I can never say the name, since that would skew our research data. Seeing a knife, she names her son, and I say "Yeah, boys always want those, don't they?" She can't say "knife". We move on.

Cara has good days and bad days. On the good days, she keeps her spirits up and sweetens my day with her humor. On her bad days, she despairs, greeting each new picture like an old friend turned traitor. She's dignified about it. Sometimes I don't even notice that she's at the breaking point until she digs in her bag for a tissue. I pause the tape recorder and wait while she folds it neatly and dabs her eyes and nose. I feel like an intruder watching her cry. When she's ready again, she nods, shaky-breathed, and faces the computer resolutely. God, the courage it must take her just to live.

A picture of a bathroom. "I need to use the-- I need to use the-- Oh, my God."

A picture of a shovel. "I know it! I know it but I can't... say it."

A picture of a seal. "Seal. Oh, my God! Seal!" A small victory. Afterward, she gives "seal" for the next five pictures, shaking her head in irritation. "No, not seal. Seal. No!"

I record her voice on tape, her responses on paper. When she whispers prayers, I hesitate, holding my pen an inch from making a mark. A brief battle in my head. . . if my respect for her privacy wins, I don't write them down. If my respect for her struggle wins, I copy the words precisely, thinking that someone will read them on my notes and know that here was not just aphasia; here was a person, struggling and blinking back tears, and "Oh God, please. Jesus, help me." It seems the least I can do, when my own words are so feeble. How many times can I say "It's okay" when it's clearly not or "We're almost done" when the length of the session isn't what hurts her? How much comfort can "You're doing fine" give to someone who once spoke fluently?

Since Cara can't drive, she takes a cab in. Her usual cab driver is often late, causing annoyance to both of us. Perhaps if he had a good excuse, it would be different, but he has too many excuses, and many implausible. Ten minutes after he is supposed to pick her up, he calls my cell. "I'm just turning on Main Street now," he says over the roar of traffic, "I'll be there in five." Ten minutes later, he calls again. "I'm on Main Street now, traffic's terrible. Don't worry, though, I'm five minutes away." I just sigh. I could ask for a different driver, but Cara likes this one. The others, she gives me to understand, have dirty cabs or drive like lunatics. I would just deal with those inconveniences, but then I'm too sweet by half, or so I'm told. Cara is sweet, too, but she doesn't take things sitting down.

One day the driver, Tim, is late again. I wait with Cara in the lobby, watching the snow outside. The lobby is full of patients waiting for para-transit; they listen with sympathy to my many phone calls with Tim. "What time will you be here?" I ask. An elderly black woman shakes her head at me. "Five minutes?" I say, "Okay, we're in the lobby." Five minutes come and go, and I see a familiar tension in Cara's body as she stares out the window. I wonder if she can say "cab" or "driver" or "road". I know she can't.

"Honey, that's just awful," the black woman from before says, shaking her head. "You've been waiting here forty-five minutes."

Cara jerks her head, hearing from someone else the words she wants to say. "I know," she says. "It's bad." Much head-shaking goes around the little circle of patients. Some have casts or wheelchairs. Others, like Cara, must have less visible difficulties. The conversation turns to rides and people's longest waits. Finally, we see the cab outside. I stand up in relief.

"He's here," I say to Cara.

"I see him," she says, unmoving. She's stiff, staring straight ahead. Outside, Tim waits in the cab, sure that we see him, but Cara acts like she has not.

"You ready to go?" I am uncertain, poised to walk out, but tethered by her stolid frame in the lobby chair.

"He sees," she says, and points down at the floor. Outside, Tim gets on his cell and calls mine. It rings in my pocket and I reach for it, but Cara stops me with a gesture. "Is cold, for you," she says. She sits.

Our elderly friend from before comes to my aid. "She's right," she tells me. "The cab drivers are supposed to come in for you. You don't go out to him."

I take a seat next to Cara, then, and stare straight ahead, like I don't see Tim outside. Finally he comes in, looking less sure of himself than usual.

"Hey, you ready?" he ventures. Everyone in the lobby stares at him.

"We've been ready, "I say, handing him the payment voucher our research grant supplies. He signs it and makes for the door, stopping when he sees Cara still in her seat. He comes back. "How are you, Miss Cara? You ready?"

She deigns to look at him, then. I can imagine her thoughts and wonder if they're wordless, or if she can speak inside her head. He made her wait, so she made him wait. She didn't let him get away with it. She has a little control back. "Yes," she answers. She stands up and sails out, dignity intact. Tim straggles after her, a chagrined little tugboat in the wake of the Queen Mary.

I can't stop smiling all day.
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