This is Paul

Original post Janury 9, 2013

This is my brother, Paul. He turned 60 years old in December. Paul is wheelchair bound, and lives in an assisted living facility in Cincinnati. Eight days ago he choked while trying to eat some turkey. You can't see from this angle, but remnants of a tracheotomy at the base of his neck are apparent when you look at him full on. We think that scar tissue may have something to do with the choking. But that is only a layman's diagnosis.

Since the incident on New Year's Day I have tried to navigate health care for him, often feeling isolated, alone and ill-equipped to know the right path to take. Paul has just been moved from one hospital, where even the doctors couldn't get a feeding tube to stay in his body, to a place where we hope his problem will be solved and he can regain his limited freedom. He has been 8 days without food or nutrition. 

Usually, I see my brother once every two months for lunch or to celebrate a birthday. Since he's been in the hospital my involvement with him has increased and I see him every day. Old memories have surfaced that I thought were long dealt with, memories of the day that changed our family's life forever.  It was a warm June day, I was working as a waitress, watching news reports about the Beverly Hills fire that had occurred just three weeks prior. That was the last fire Paul fought in, helping to save as many people as possible as a new Emergency Medical Technician. On that June day, Paul was looking forward to full time employment with his hometown fire department - a place where he had volunteered since he was 16 years old. 

But Paul had a run to make with a private ambulance company. The patient they transported had gone into epileptic seizure. Paul was driving with lights and sirens blazing, when a garbage truck broadsided his ambulance, failing to stop to allow the ambulance to go through an intersection. 

For three days we waited. No one could predict whether he would live or die. Doctors saw little brain activity and fore warned that he had slim chance of regaining any mental capacity. He made it through those three days, stayed in a coma for four months, and one day tried to bite my mother's hand as she combed his hair. She knew then that her efforts not to give up on him were paying off. 

In the ensuing three years, Paul had speech, occupational and physical therapies. He and we were in and out of one facility after another. I supported my mother with transportation, spelling her from duties with Paul, and generally trying to help. I was a 21-year-old young woman at the time and only recently finding my own wings, just to have them clipped by a brother's predicament. 

Paul and I have never been especially close. And if you've never talked to someone with severe TBI (traumatic brain injury) you should try it sometime. It's a great lesson in patience, which I have had little of for a brother who always needed more from me than he could give. 

I've walked the halls of two hospitals now with growing compassion for a man who seemed to die 36 years ago, but still lives and still talks and still would love to see a daughter he's been estranged from for years. So I buck up, try not to get angry with doctors who tell me that when they insert a feeding tube in Paul's stomach they will teach him how to administer his own food. I guess those doctors didn't really look at him, didn't see his clenched hand, and glazed over eyes that don't see too well. It's another lesson in patience for me. These doctors know little of TBI or Paul. I buck up, when  I have to listen to one more person tell me they don't know what is going on and they hope to have that feeding tube in him soon. I buck up when I ask Paul how's he doing, and he says, starving.