Here is the third chapter of Dreaming Out Loud, the book about my mother’s stroke.

Chapter 3

The automatic doors slide open and Paula marches into the ER with her familiar, purposeful gait. One of her more endearing qualities is her absolute “take charge” attitude. Never one to suffer the slings and arrows of outrageous fortune, she resembles my pre-stroke mother more than I do. Sometimes I feel as though I am a spectator in my life, powerless to alter its trajectory as it flashes past me. By contrast, Paula is unafraid to challenge the world, daring it to try and knock her down. Sometimes she lands on her ass; sometimes she triumphs.

Looking around the waiting room, she spies us sitting along the wall. “Why are you still in chairs?”

“Thank God, you’re here.”

“Have you checked in with the front desk?”

“Of course. We finished the paperwork and we’re waiting to see the triage nurse.”

Paula consults her wristwatch. “How long have you been sitting here?”

I look at my own watch, and shrug. “I dunno. Maybe forty-five minutes or an hour.”

"Jesus."

Paula shifts her gaze down at mom and softens her tone. “How are you feeling, Laura?” She places her hand on the old lady's forearm in a gesture of friendship.

Mom’s eyes are half open. “Hot. Tired.” Her voice is weak, barely audible.

“I’ll see what’s taking so long.”

“You are a good ladies — um, good lady. Satis, um, satis, um, satisfied.”

Paula heads for the registration desk. For a moment, I actually feel sorry for the Nazi-nurse, Ken, but the moment quickly passes.

“It is hot. So hot. Baking. I have sat here for the baking.”

“Here.” I reach over and help her slip out of her jacket. “Better?”

“Umm. So hot for the baking.”

I pat mom’s hand, surreptitiously feeling for a pulse. “Not much longer now.”

Paula and Ken engage in a heated discussion. I cannot hear their words, but I see flailing arms. Their spirited tone reverberates throughout the waiting room. Even the patrons moaning quietly in their own corners gaze at the brave soul who dares to confront the all-powerful Ken.

Paula charges back to the chairs along the wall.

“What’d he say?”

“He’s an asshole.”

So we sit. Time ticks by; people come and go; doctors and nurses zip past. Whenever we spy a white lab coat or a pair of scrubs, we smile and look up hopefully. Our hopes are dashed. Every few minutes, Paula rises and assaults the impregnable fortress that is the front desk. Each time, Ken the Visigoth sends her reeling back against the wall. Invariably, she pronounces him an asshole. This cycle becomes our routine.

Eventually, mom leans into a nearby chair and curls into a fetal position. She uses her windbreaker as a pillow.

Frustrated and seething over the lengthy time delay, Paula yanks her cell phone from her purse and speed-dials a number.

“Who are you calling?”

She holds up a finger to silence me. “Gail. It’s me. What? Yeah, I’m there now. Hmm? I don’t know. Prob’ly so, but I don’t know for sure — we’re still in chairs. Yeah, that’s right. I know. I know. Oh, would you? Thank you so much. Thank you. Okay, ‘bye.”

Paula hangs up and turns to me. “Gail’s going to call an ER doc she knows who works here and tell her we’re still sitting in chairs.”

I nod. There’s nothing like having friends in high places.

“This is un-fucking-believable.”

“Yes. It is.”

As it turns out, though, intervention is unnecessary. Ken appears with a wheelchair and his ever-present clipboard in hand. “Ms. Martinez?” He leans over the supine form reclining in the chairs. “They’re ready for you now.”

“Mom, let’s go.” I snap my fingers.

She is half-asleep and not inclined to cooperate. “Sats?”

“Mom, please.”

Ken moves over to her and slides his hand beneath her head. “Let’s go, Ms. Martinez. They’re ready for you now.”

Paula sneers. “Mustn’t keep the doctor waiting.”

With no choice in the matter, mom sits up and surveys our anxious faces. “Sats?”

“Can you step into the wheelchair or do you need assistance?” Ken’s attitude, formerly aloof and confrontational, has changed dramatically. He is now solicitous and respectful.

“Sats? Good ladies. Baking.”

“Hospital policy, ma’am.”

Who is mom to contravene hospital policy? She rolls her eyes, but succumbs to the inevitable. With an exaggerated sigh, she stands, takes a wobbly step, pirouettes, and sits down, hard, in the chair.

“Sats on the ladies.”

Ken wheels her through the throngs of people milling about in the lobby, all awaiting the chance to be poked and prodded. “Beep, beep, coming through. ‘Scuse me, folks.”

"Beep, beep," mom mutters.

I grab her windbreaker and follow along. Paula is at my heels.

We move beyond the registration desk, leaving half a dozen nurses in our wake. I glance back at our comrades in the lobby. We leave their moans, cries, and cacophonous chatter behind as we slip through double doors leading into the interior of the Emory Eastside Medical Center. I am not sorry to see the waiting room fall behind us.

We enter a completely different world. Passing through the double doors, we are engulfed by a modern hospital, a giant behemoth crammed full of people, machines, and twenty-first century technology. If the waiting area is a sea of humanity writhing and moving about as an indistinct, undulating mass, the back hallway is Technology Row. Everywhere we see computer terminals, wires, IV bags hanging from shiny metal poles, and expensive-looking gadgets on wheels. I watch a flashing line graph on a green screen as it belches out information far beyond my poor powers of comprehension. Everything is white and clean-looking. In the waiting room, one can imagine pus and puke and piss and blood everywhere, a monument to human misery and disease. This white sterile environment sends a subtle, yet powerful message: disease is not welcome here and will not be tolerated.

Men and women wearing white lab coats and a variety of colored scrubs bustle about; they are important people in a hurry. They consult clipboards, monitors, and tiny, complicated-looking handheld digital devices that probably have their own satellites orbiting somewhere miles above our heads. Their faces are masks of concern and concentration. These are serious people shouldering serious responsibilities.

I whistle. “Look at all this. I feel like a backwoods rube.”

A small black woman in her twenties meets us at the nurse’s station. Her name badge identifies her as “Kelly.” She wears green scrubs with a stethoscope draped around her neck.

Ken hands the clipboard to the diminutive young lady after he wheels mom to a stop. “Ms. Martinez needs to be admitted and prepped.”

“Thank you, Ken.”

He leans down in front of the wheelchair. “Goodbye Ms. Martinez. Good luck to you, ma’am.”

She nods, so exhausted she can barely lift her head from her chest.

He smiles at her, stands, and looks at me. “Good luck.” His brow is furrowed, his manner somber.

I nod as he turns back toward the waiting room.

Paula mutters a succinct farewell under her breath. “Asshole.”

The nurse plops down onto a stool with wheels. “I’m Kelly Peterson-Neubauer, a triage nurse here at the hospital. What seems to be the problem?” She leafs through the pages of the clipboard containing our admission forms as she rolls toward my mother’s wheelchair.

Paula beats me to the punch. “She’s had a stroke.”

Kelly Peterson-Neubauer blinks up at Paula. “Has someone provided you with this diagnosis or are you drawing that conclusion yourself?”

Paula gestures at mom. “It’s the classic signs of a stroke. She has the risk factors — hypertension, lack of exercise, smoking, overweight. She’s confused, lethargic, and droopy. Just look at her.”

“Are you a nurse or a doctor?”

“No.”

Kelly Peterson-Neubauer purses her lips. “Umm.”

“I am a practice manager for physicians at Piedmont Hospital.”

“Umm.”

I glance at mom to see how she is handling this discussion, but she is staring off into space, oblivious to the world around her. She looks slightly droopy, as though her face is not composed properly. I envision a sagging front porch on a decrepit house.

Kelly Peterson-Neubauer examines mom intently. “Ma’am? Ma’am?”

“Mom.” I snap my fingers in front of her face. “The lady’s asking you a question.”

Slowly, as if she is emerging from a fog, mom turns. “Beep, beep. Good ladies for the baking?”

Kelly Peterson-Neubauer reads the clipboard. “Is it ‘Mar-tee-nez’ or ‘Mart-nez’?”

I shrug. “The first one’s better, but either one works.”

“Please let her answer, sir.”

"Okay. Sorry."

“Ma’am, how do you pronounce your last name?”

“Sats. Good ladies for the baking.” Mom looks as weary as I have ever seen her. She can barely hold up her head; it rolls on her neck like a globe wobbling on its axis. Her eyes are glassy. She appears to be grossly intoxicated.

Kelly Peterson-Neubauer extends her arms. “Can you squeeze my hands?”

Mom gazes at the woman’s face, down at the outstretched arms, and back at her face. “Good ladies for the baking? Sats?”

“I want you to grab my hands and squeeze them as hard as you can.”

Mom looks at me.

I nod. “Go on.”

With a sigh, mom grabs the woman’s hands and squeezes.

“Squeeze. Squeeze.”

“Beep, beep. Good ladies for the baking.”

“Okay. Good. You can stop. Thank you, ma’am.” The nurse turns and jots something on the clipboard.

Mom gasps for air. The exercise has left her breathless.

Paula frowns. “She needs help.”

Ignoring the comment, Kelly Peterson-Neubauer removes a penlight from the pocket of her scrubs and bends forward, shining the light in mom’s eyes from the front and sides. Manipulating mom’s head repeatedly, the nurse is thorough in her examination. Again, she jots notes on the clipboard.

“Ms. Martinez, I need to take a medical history from you.”

Mom turns to address Paula and me. “Good ladies for the baking.”

“What?”

She points. “Good ladies for the baking.”

Kelly Peterson-Neubauer interprets the command. “You want to answer these questions in private. Is that right?”

Mom nods her head vigorously. “Sats. Right.”

Looking up, Kelly Peterson-Neubauer points at me. “Are you her son?”

“Yes, ma’am.”

“If you and your wife wouldn’t mind waiting over there, that would be fine.” She points to a small portable wall partition about 20 feet away.

I shrug and look at Paula. “Okay.”

“What’s up with her speech?”

“Please.” The nurse points.

Paula and I amble over to the partition and stand just out of earshot.

“She thinks you’re my wife.”

“It’s a natural assumption.”

Kelly Peterson-Neubauer commences her questioning, but mom’s face is curiously blank. She frantically rubs her forehead and examines the ceiling tiles for guidance. After a minute or so, I see the nurse motioning to me, so I move closer.

“She doesn’t remember if she’s had any other circulatory problems before.”

“She has a carotid artery aneurysm.”

Mom waves at me as though she is angry. Her nostrils flare.

Reaching out, the nurse gently touches mom on the arm. “You don’t have a carotid artery aneurysm?”

“Sats. Good ladies for the baking.” Mom wildly waves her arms and points at me. “Good ladies for the baking.”

I take three steps backward. Paula walks over and stands at my side.

“So do you have the aneurysm, Ms. Martinez?”

Mom shakes her head, yes.

“Any other circulatory problems?”

Mom looks at the ceiling as she ponders the question. Kelly Peterson-Neubauer looks at me for guidance.

“She has high blood pressure.”

Mom whips her head around and glares at me. Her eyes are ablaze. “Sats. Good ladies!”

“Okay. Okay.” I hold up my hands.

Mom waves me away.

Paula and I step back in unison as though we are developing a synchronized Vaudeville act.

Kelly Peterson-Neubauer hunches over the clipboard. “So, let me make sure I understand. You have a carotid artery aneurysm and high blood pressure. Anything else I should know about with your circulation?”

When mom pauses and looks off into space, I shake my head. No.

The nurse nods. Message received. “Do you know your blood pressure?”

Mom frowns, and I nod, no.

“That’s okay. We have to take it, anyway. I just wanted to know what is considered normal for you.” She reaches into a drawer and produces a blood pressure cuff.

“Sats. Good ladies for the baking.”

“You know how this works. I’m going to check your blood pressure.”

Mom sighs. “Sats. Sats. Sats.”

As Kelly Peterson-Neubauer wraps the cuff around mom’s arm and pumps it up with a small hand-held device, Paula and I collapse into two nearby chairs. We sit in silence.

“Your BP’s a little high.” She removes the cuff and scribbles on the chart.

“Sats?”

“It’s higher than we would like.”

“Sats?”

“It’s higher than we would like to see it. Do you feel flush or hot?”

Mom shrugs.

“So that is yes?”

Mom nods in agreement.

Kelly Peterson-Neubauer finishes writing and looks up. “Now, then, Ms. Martinez. Have you ever had any medical procedures that required surgery or hospitalization?”

At the sound of a new question, Paula and I stand and amble closer to the partition. Mom spins around to eye us suspiciously, so we lean back and flatten ourselves against the partition.

“Sats. Good ladies for the baking.”

We say nothing. After a moment, she turns her attention to the nurse. “Sats? Good ladies for the baking.”

“I need to find out if you have ever had surgery or required hospitalization.”

We wait as mom considers the question. Slowly, Paula and I lean away from the partition until Kelly Peterson-Neubauer and mom come into view. The nurse looks at us beseechingly.

“She’s had several surgeries throughout her life.”

Mom erupts. She is a short, squat Vesuvius as she slaps her hand on the desk. Startled, the nurse jumps. “Beep, beep! Sats! Sats! Sats!” I have seldom seen my mother so angry.

Kelly Peterson-Neubauer places her hand on mom’s arm. “Ms. Martinez, it’s okay. It’s okay. Let’s just calm down.”

Mom points at Paula and me. “Sats!”

“I understand; I understand.” She speaks with a patient, soothing voice.

Mom hikes a thumb at herself. “Beep, beep. Good ladies for the baking!”

“Normally, Ms. Martinez, I would say that you could take as much time as you needed. But you prob’ly saw how crowded the waiting room is today. I need to have your son and his wife come over and answer these questions so we can move along quickly.”

“Sats for the baking.”

“Ms. Martinez — look at me. Look at me.”

Frowning, mom gazes at the nurse.

“I am a triage nurse, and I have many, many patients waiting to see a doctor.”

“Sats for the baking.”

“Do you understand?”

“Sats.” She sounds resigned, defeated. “For the baking.”

“It appears you are suffering a stroke. Part of the problem with a stroke is that it is difficult to complete your thoughts and form words. That’s what’s happening now. I want your son to help me get a complete medical history so we can admit you to the hospital and get you some help. Okay?”

Mom folds her arms and looks away, pouting. She will not cooperate with this conspiracy to steal away her independence.

“Ms. Martinez — do you understand what I’m saying?”

She is still angry and petulant, but what can she do? “Sats.”

“It’s not that I want to have it my way, ma’am. I’m just trying to do what’s in your best interests.” Kelly Peterson-Neubauer motions to us. Paula and I emerge from behind the partition and shuffle forward.

“Mr. Martinez — is that your name, too?”

“Yes, ma’am.”

“So how did it first come to your attention that there was a problem?”

I launch into a shortened version of the narrative.

Kelly Peterson-Neubauer wheels around to address mom. “Is that pretty much how it happened, ma’am?”

Mom shrugs. “Sats. For. The. Baking.”

I continue my narrative, offering an assessment of causes and effects as best I can. Mom rolls her eyes, sighs, and fidgets in her chair throughout the ten minutes or so I take to complete the narrative and the forms.

The nurse scribbles on the clipboard as we speak. “Uh-huh, uh-huh.”

At the conclusion of the interview, Paula cuts to the chase. “When can she see a doctor?”

Kelly Peterson-Neubauer is already reaching for the telephone. “I’ll get her on a gurney and we’ll have someone see her in a little while.”

“How long is ‘a little while’?” Paula is nothing if not assertive.

“I wish I could tell you, but we’re so backed up tonight that…. Hello? Yes, this Kelly at extension 164. I need a gurney for an admit for Dr. Rollins. Thank you.” She hangs up and turns to face us.

I rub my aching neck. “Are they coming soon?”

“It won’t be long now.”

Paula nods. “Finally. We’ve been waiting forever.”

Mom protests one last time. “Beep. Beep. Sats. For. The. Baking.”