Labor Days

Monday, July 28: Day 72

I was awake at 6:00 a.m. for the morning rituals of washing, getting dressed, getting help to sit upright. Penny helped me make the transfer to my wheelchair at 8:20. Each day she encourages me to try something new, to be more independent, reinforcing me for trying, not just succeeding.

Linda worked on my small motor coordination. I tried to screw a large nut onto a machine bolt mounted in a pegboard. I’ve never been mechanical, but this was ridiculous. After repeated failures, I threw the nut. Linda told me that was unacceptable. I said that I was throwing the nut at the box, not at her. Linda told me that was unacceptable. I told her I was throwing the nut at myself. For the third time, she told me that was unacceptable, and then she had me practice just touching my thumb to other fingers. That was acceptable.

At 11:00, Kim and Linda worked together. They directed me to roll over onto my stomach from a lying-flat position on the mat. I did this in one shot, leaving my nose pressed hard into the mat. From this position, they told me to slide my arms along the mat, to raise myself up on my palms and elbows. Linda braced my palms and wrists on the mat while Kim held me around the pelvis and then tugged my hips backward until my knees and hips were perpendicular and I was supporting myself with my palms on the mat. I had achieved a four-point position, kneeling on my hands and knees, huffing and puffing in quick, short breaths.

I thought that was pretty damn good and was ready to bask in the success of the new position. Kim and Linda interrupted this reverie: “Tom, we’re going get you up to another position from the four-point.” With Kim holding onto my pelvis and Linda bracing my hands, they inserted a large therapy ball under my torso and had me wrap my arms around its circumference. They rolled the ball until I was kneeling upright. After about two minutes kneeling straight up, I asked to be put down. They extracted the ball and gradually let me down from the two-point to the four-point on my knees and palms, and then all the way down until my face was once again squashed into the mat.

Sunday, August 3: Day 78

Pat researched how to reconstruct the first floor at home.  Thank God I have a spouse who is so knowledgeable about building materials, architectural blueprints, and the management of a construction project.

Mark Winograd showed up unannounced. He got to see me transfer from the chair into the bed and completed his standard assessment of my upper and lower extremities. He observed several positive changes, neurologically, in the ten days since he saw me. At that time, he was very upset and downright pessimistic about my long-term prognosis. Now, his assessment of my upper extremities was 4+/5 for my arms, 3-/5 for my legs, but still 0/5 below my ankles. 

He urged me to be more assertive in managing my rehabilitation regimen, especially on the issue of getting overtired by emotional or physical activities. I need to tell others immediately when I felt woozy or fatigued. He reemphasized that with GBS, fatigue will have an adverse effect on all of the other positive outcomes. My physicians have disagreed over the rate of my withdrawal from the steroids. Mark was conservative and wanted to go very slow, not in any way compromising my current progress. He wanted to monitor the possible side effects. The sobering fact remained that, as he said to me one week after we met each other, “This will be a life-long issue, and you will follow up with me for probably the rest of your life.  GBS will be a disabling condition, and there will be the potential for relapse for a long time.”

Thursday, August 7: Day 82 

I attended my first Valley of the Sun staff meeting.  Linda described the dramatic improvement in all areas over the last two weeks, noting my comment: “Now I see how all the pieces fit together in this rehab process.” I’ve gained in strength, balance, transfers, and wheelchair mobility. Limited small motor coordination and decreased to non-existent sensation and proprioception in my lower extremities impaired my progress on “ADL’s”—activities for daily living (such as dressing below my waist, eating, bathing, toileting, working with small objects). Kim noted that I tolerated four hours sitting up in the wheelchair daily as well as longer stints in the standing frame. The staff recommended ordering me a wheelchair, slide board, and portable commode to assist me in accomplishing functional autonomy before discharge. “Functional autonomy” was the capacity to transfer back and forth from bed to chair to commode without assistance. Whatever independence could be achieved in the hospital, the gains made as an outpatient would be enhanced, and the long-term prognosis for walking again could be better. The team asked Linda to schedule a home evaluation so that VSRH could make recommendations for safety and access changes in that environment and to simulate more closely what I would experience after discharge.

Saturday, August 9: Day 84

This was our twenty-seventh wedding anniversary. Pat had to work at the Art Institute on an all-day workshop, so we postponed our celebration until Sunday. I tried to remember hour-by-hour where I was on that 1970 Sunday in New York—at my parents’ house for the last time as a single person; with my wedding party donning our tuxedos; an almost car accident on the Brooklyn-Queens expressway; at Fordham University Church; at our dinner and dancing reception with 175 people; the get-away to our new apartment for the night; then to Lake George for a brief honeymoon until my Selective Service interview for conscientious objector status. Our first date was Valentine’s Day, 1965. Thirty-two years together. Twenty-seven years married. For better or for worse. In sickness and in health.

Wednesday, August 13: Day 88

I went home for the first time in thirteen weeks.

The issues for the future emerged quickly outside of the cocoon of the rehabilitation center. The van driver rolled the wheelchair over my foot on the way into my house and on the way back into the rehabilitation center. No matter how much I planned, unexpected things were going to happen, and I wouldn’t be able to avoid them all.

Our house entrances had much narrower access than I remembered. When we got inside, the carpet was like wet sand for my wheelchair. I saw the unpacked suitcase that I had brought home so long ago from Maryland. It was still there in the family room. Our lives had been in suspended animation since May.

Pat, Linda and Kim discussed the changes necessary to accommodate my return home in a wheelchair next month. While they went upstairs to evaluate beds and bathroom facilities, I tried to take in what I had forgotten about my house, to capture in my mind’s eye all the different things and places that I didn’t want to forget when I returned to VSRH.

Kim and Linda’s evaluation noted that there was no access to the kitchen for a person in a wheelchair. Knobs on the back of the stove were a safety issue for cooking. The door frame of the downstairs bathroom was too narrow, and the cabinet below the sink had to be removed so I could reach the sink. There were no bathing facilities on the first and second floor—eight steps to a landing and then another eight steps—would be inaccessible for a long time, perhaps forever. Deeply padded carpets made wheelchair mobility almost impossible. A ramp would need to be installed to allow entrance through the front door.

I was overcome with emotion when we left. I was eager to get back to the structure and safety of the hospital.

We were back at the hospital by mid-morning, and I went back to bed to rest before lunch and the afternoon’s exercises.  In the gym, I stood up using a set of parallel bars to support my body and then gradually let my arms down. I put weight on my feet after spending thirteen weeks on my back or my butt. Like the gymnast, almost all of my weight was being supported by the upper body strength that Linda had helped me develop over the past several weeks.

Thursday, August 14: Day 89

Kim and Linda had a lot to summarize in their weekly therapy reports:

1) Able to feed self after set-up, using built-up spoon; requires assistance to cut food;
2) Moderately independent in grooming; uses electric razor independently;
3) Starting to dress upper and lower body while in long-sitting position in bed;
4) Toileting still requires maximum assistance with suppository;
5) Supervised slide board transfers to all level surfaces;
6) Independent wheelchair mobility on tiled and level surfaces; moderate assistance on uneven terrain;
7) Standing in parallel bars from elevated surface with minimum assistance from two therapists to maintain standing for thirty seconds; 
8) Home evaluation completed and plans made for increased accessibility.

New goals were proposed based on the previous two weeks’ progress:

1) Independence in all bed-to-wheelchair transfers;
2) Independence in bed mobility in standard bed;
3) Independence in bed-to-commode transfers;
4) Independence in toileting activities using drop-arm commode at bedside;
5) Sit to stand from elevated surface with minimal assistance of one therapist;
6) Stand for three minutes in parallel bars with minimal assistance of one therapist;
7) Minimally assisted wheelchair-to-car transfer.

September 15 was not that far away, and much work remained.

Friday, August 15: Day 90

Kim and Linda started me in a prone position on the gym mats. I inched up my elbows to get to a four-point position, then moved my hands slowly up my legs to achieve a two-point position. I placed my hands on Linda’s shoulders in front, with Kim’s hands wrapped around my pelvis. They walked me on my knees forward and backward. These are more new pieces in their therapy-learning plan—four-point kneeling and crawling, two-point kneeling and walking, standing, and ultimately walking on my legs again.

Monday, August 18: Day 93

I rose at 5:30 a.m., meditated, completed the daily regimen of medication and laxatives, shaved, and dressed by myself. I decided not to rely on the safety of a Depends diaper all day. I was tired of the chafing and the limited mobility. Marg helped me to use the bedside commode, successfully, for the first time today. Ninety-three days is a long time not to be able to do a simple function that we learn when we are just two years old.

In the gym, I was able to get to a standing position from the mats to the parallel bars. I took one hand off the parallel bars and maintained my standing position momentarily. Kim and Linda coached me to put both hands on the bars and to lift one leg at a time while standing in place. Finally, I took my first steps with the parallel bars as a support. They described that effort as “walking with my shoulders,” because the strength I’ve gained in my upper body was doing more of the work than any weight bearing and movement below my hips. Kim announced that tomorrow we would begin to work in the pool, first to learn all the different steps without full weight, then continue to practice on land, with more and more weight on my legs.

Tuesday, August 19: Day 94

Kim got into the pool with me and wrapped a flotation device around me. Images of the toddler again came to mind as she held me and got me accustomed to the water. It felt wonderful. I took my first steps along the parallel bars. They were more like bouncing hops using my upper body strength, as I had done in the gym. The ninety-degree pool water felt like a cocoon. She had a hard time coaxing me out of the pool, but after only twenty minutes, I was exhausted and wanted to get back to my room, dry off, change clothes, and nap.

Wednesday, August 20: Day 95

Back on campus, ASU West staged its first convocation, and the theme was “Reach for the Stars.”

During my morning gym session, I stood from the wheelchair. Pushing myself off from the back of the chair, with Kim in front and Linda behind me, I grasped the parallel bars with both hands. I could feel Kim braced against my knees so that they wouldn’t buckle, and Linda’s arms wrapped around my shoulders with her unborn child nestled into the small of my back. I took my hands off the bars and gently placed them on Kim’s shoulders with Linda still wrapped around me. I kept thinking about how lucky I had been to be assigned to these two women. I thought about the new person growing inside Linda. Silently, I wished all four of us a very long and rich life. This was the first time that I stood again, and with the full weight of my body borne by my legs.

Mario Parise, the nephrologist who had completed all of the plasmapheresis treatments at Thunderbird Samaritan, returned from vacation, not having seen me in three weeks. He was stunned as he sat on a mat and watched me do my workout. He promised to pay for the first round of golf at Arrowhead Country Club and started negotiating strokes from me already.

Gebe Ejigu and Ramsey Eric Ramsey processed into my room at 9:00 p.m., dressed in their academic regalia, having just come from convocation. They were a sight for my grateful eyes, the end of a wonderful day in my rehabilitation world. Neither had seen me in a while, and I shocked them by raising my legs, wiggling my toes, and sitting up in bed without assistance. It was just too much for Gebe to stay dry-eyed.

Friday, August 22: Day 97

Since I walked in the pool yesterday, Kim decided to have me stand without using the parallel bars. She gave me a walker for safety and stability. I got my shoulders, hips, and feet all aligned in a standing position and took my first steps from one mat to another across forty feet of open space. Linda braced my back and Kim held onto the safety belt wrapped tightly around my waist. After resting for a moment, I stood up and walked back across the middle of the gym, slowly but surely making my way back to the mat. The entire physical therapy staff, hanging out for their Friday lunch gathering, had spotted me taking my first steps across the gym. When I finally made it back, they cheered the three of us.

Tuesday, August 26: Day 101

Physical therapy today was quite a workout. For the first thirty minutes, Kim took me out in the parking lot in my chair and taught me about the strength and the safety needed for going up and down ramps. When Linda joined us at 11:30, they told me that I needed to practice a safety exercise because I would someday fall out of my chair. When that happened, I could lie there for the day, crawl on my belly to a phone, or get back in the saddle with as few bruises as possible. They taught me how to fall out of my chair onto a thick, wrestling mat on the floor. Next, they demonstrated how to roll on my back, kneel in front of my chair, extend one leg as a strut, and lift myself back into the chair using my legs and arms, while gripping the side arms of the wheelchair locked in place. I accomplished this task quickly and easily. They made me do it again so that I could practice from the opposite angle, using my left leg as my strength point.

At 2:00, I went into the pool with Kim and walked with three-pound weights strapped around my ankles. I was able to walk without using the handrails, tucking a child swimmer’s device underneath my arms. I walked more easily than ever before around the pool, with the benefit of less weight. I started to imagine, as I walked in the pool, the real possibility of walking out of the rehabilitation center next month. Just standing from a wheelchair was no longer a goal.

Sunday, August 31: Day 106

For the first time since I’ve been in the hospital, I shaved, brushed my teeth, and washed up in the bathroom while sitting in my wheelchair. After eating breakfast with other folks on the unit, I completed a wheelchair lap around the entire complex. I then decided it was finally time to go out and to be in the sun again. I hit the handicapped wheelchair button, the doors opened, and I did two laps around in the inner courtyard. After more than 100 days in rehabilitation, I thought about needing sunscreen.

Monday, September 1: Day 107

Labor Day was scheduled like a Saturday, for working in the gym with the therapists, and we did work! Pat joined me, Kim, and Linda in the gym at 10:30. It felt like the scene from the movie, Dirty Dancing, when the professionals tried to teach the amateur how to do a rumba. Kim positioned herself behind me with a light touch on the safety belt. Linda stood in front of me and I placed my hands on her shoulders. The three of us then walked across the gym. After my brief rest, Pat asked to replace Linda in the front position. Two years ago, we enrolled in a ballroom dancing course at the local community college. My preoccupation with the exact placement of my feet was the same then as it was today. My Labor Day shuffle reflected a “pre-existing condition” and not just GBS!

Thursday, September 4: Day 110

Working with Kim today revealed another set of wonderful qualities in her teaching. I could not stand up from the wheelchair. I couldn’t stand from a chair in the pool on Tuesday, nor could I accomplish the same task yesterday. I was frustrated, then anxious when it felt like I was going to fall down. My face must have shown those feelings. Kim’s eyes and her touch were exquisite—

“Tom, it’s not a matter of trusting us to not let you fall. It’s you trusting yourself. I’m asking you to do new things this week, and it has to be scary. It will take some time. You can’t do everything the first time and that’s OK. Look, we could have you cruising around here in a walker and with assistance, but we want to teach you how to walk again completely unassisted. That’s going to take time to learn. Your back muscles are weak. Your legs are just beginning to come back. This will take time. It’s OK, and you’re doing just fine.” She placed her hand lightly on my shoulder, rubbed it, and smoothly changed the topic.

After a long nap, I went to the gym, stood up from the wheelchair, walked down the six steps into the pool, and began in earnest to re-learn how to stand and balance my trunk and legs. After forty minutes of practice in three and four feet of water, I finally got the hang of it. After completing the balancing exercises, Kim had me jog in place in the four-foot end of the pool. When I finished, I marched back up the steps, walked out of the pool, and went back to my room for a shower. All things are possible with a good teacher!

Friday, September 5: Day 111

Alex Piatka, the neuropsychologist, and I had our traditional Friday afternoon conversation. As I’ve gotten to know him, the conversations go to places that I don’t expect and become rich reflections on rehabilitation of body, mind, and soul. 

What is rehabilitation time? How do you measure time past? Time to go to being better? What is change? 

How is what I see (such as muscle strength, coordination) different from what I don’t or can’t ever readily see (such as remyelinization, proprioception)?

What really has changed in my life?

What has the experience of facing death or total dependency meant for me?

What has the experience of love, of nurturance, of profound caring by so many people in such deep and broad ways meant for me?

What does it say about how I have lived my life to date that many people feel so positively about me and were so upset by my illness? Or was it my possible death at such an early age and the parallels to their own lives that motivated such responses?

I am existentially tired and have chosen to ignore this fatigue for so long.

I have spoken of happiness and legacy, but have I really known what they are?

Can I just take a time-out? 

Will I continue to walk away from this syndrome? Or when will the wall hit me? When will the music stop?

Linda and Kim said today that what they saw on September 5 was what they predicted would be the best I would ever get to in the rehabilitation process, and by July 1998 at the earliest.

My curriculum vitae needs no external validation. I should be at the stage of my career where all of the choices about how I spend my time ought to be my own.

Why not think and then write about what I say I love the most and have done the best for the longest time—to teach?

How will I be on September 5, 1998, when the bell rings for fall semester again

Wednesday, September 10: Day 116

The countdown to discharge continues daily. All my morning activities—shaving, washing, breakfast—were done as if I were at home. I was up by 6:30 and active until 12:30, when I took an hour-long nap. I stayed in my chair from 1:30 to 5:30, for a total of ten hours out of bed. As I wrote this at the end of the day, fatigued but feeling good, ten hours didn’t seem very long. When I was working, I would rise at 6:00, go to ASU West and return home at 6:00 for supper. That was a twelve-hour workday because my mind was always active from the moment I went into the shower in the morning. An extra project at night after supper—grading papers, e-mail correspondence or memos, an administrative report—would often add two to three hours more work onto the day. It was a fifteen-hour workday, five days a week. And I would always do four to eight hours of ASU West work on the weekends. When I traveled, or during the three years I worked on the Arizona Board of Regents, these hours were extended even more. 

I was efficient as well as long-houred. That’s why so much always “got done.” I didn’t ever rest during the day. Lunch was always with faculty or students and designed “to accomplish something.” I didn’t meditate. I didn’t read for relaxation.

The arithmetic of my hours was becoming clearer. Over the past three years and probably many more in Arizona and in Virginia, my workweek added up to this:

24 hours/day x 7 days/week=168 hours
15 hours/day/weekday work=75 hours weekday working hours
8 hours/weekend work=83 hours of weekly working

Seventy percent of my waking hours were being spent working, every week!

Thursday and Friday, September 11-12: Days 117 and 118

I spent all Thursday morning slicing and dicing vegetables in preparation for Friday’s staff luncheon. Six onions, five green bell peppers, six cucumbers, two bunches of celery were cut and bagged; the first onion took me twenty minutes to dice. I calculated all of the weights and preparations needed to translate the recipe for two into a meal for twenty and planned the timing sequences and the pots and dishes that would best work for efficiency and flair.

On Friday morning, I began at 7:30. Both dishes—Creole shrimp and Japanese sweet-and-sour shrimp with mandarin oranges—were placed on the table at exactly 11:55, as the occupational and physical therapists gathered. Most of the stirring and mixing I did from my wheelchair. When I sautéed the vegetables and made the sweet and sour sauce, I cruised the counter tops, trying to clear and clean dishes as I went. It was a tour de force! 

Beth took photographs as I cooked, cleaned, and quipped with all of the passers-by. Patients in therapy at the gym, pharmacists, van drivers, outpatient services staff followed their noses as the aromas of the Creole and sweet-and-sour sauces spread into the hallways. The group gathered, ate, and were all smiles.

Sunday, September 14: Day 120

I wrote this reminiscence under the gazebo this morning. Six months from now, I may remember differently, so I wanted to write before leaving here.

In May, I was hospitalized in intensive care for four weeks and received two powerful medical treatments. I got a little better, then got a lot worse, after each treatment. The doctors were never sure how bad my illness would get and whether or how much I would recover. For five more weeks, progress and deterioration mingled and the doctors hypothesized that I might have the chronic variation of GBS—chronic inflammatory demyelinated polyneuropathy (CIDP). Physical and occupational therapy went slowly. Kim and Linda did the heavy lifting in those days. Kim hoped I could be hoisted into the standing frame by July 25, and my rehabilitation accelerated. Alex, my neuropsychologist, told me that I stopped looking sick and started looking like I wanted to be in rehab and get on with it. The treatment team wanted me to be “functionally autonomous” by October 1—to transfer from my bed to a wheelchair and then to a commode using a slide board.

When I was measured for a new wheelchair, Linda and Kim took away the slide board and made me use my legs and my increasing upper-body strength to transfer myself from bed to the chair. From that day on, the first definition of “functional autonomy” was left behind and the three of us pushed forward into unexpected and increasingly positive places. Linda and Kim always seemed attuned to one another, thinking about creative strategies to accomplish new goals. They changed their roles from being my heavy lifters to my coaches. We laughed in the gym like three kids in a sandbox.

They teased me about earlier fears, but now I surprised them daily. Almost every day one of them would say—“Do you remember when we had you practice on XYZ muscle group? That was to prepare you for what we’re doing now with ABC muscle group.” Kim’s eyes would widen and her face would light up. “O.K.  So we planned a task for today’s hour and you’re done in 10 minutes. Linda, what should we have him do next?” She told me that they stopped having lesson plans carefully scripted, and now came with just a very clear idea of where we would start each day based on the prior day’s work, and then let me go as far as I could. They dragged equipment all over the gym, constructing makeshift devices for me to learn another skill. Once in awhile, they would say, “Did you see what he just did? Isn’t that a classic example of what we read about in our textbooks?”

The other therapists kept an eye out for us as well. Some would suggest a different procedure that worked for them with a different patient. On one Friday morning, someone spotted the three of us struggling to walk along across the gym floor. Linda protected me from the front and Kim held firmly to the gait belt from the back. When I finally made it to the mats to sit down, the whole group broke into applause.

No matter how long we worked or how close we became to one another, I was always scared when we pushed into uncharted, unpracticed territory. Patiently, they would answer my endless questions about risk and rewards, about how each task fit into the overall scheme of things, drawing analogies between now and prior weeks and the success that came when risky behavior was attempted.

Linda was aggressive in her verbal directives and adapted a no-nonsense, the-clock-is-ticking posture with me. Kim cut through my attempts to procrastinate by talking my way around a task. I would analyze it. I would speculate about it. After letting me run my mouth, but only briefly, she would cut me off and say, “Rest’s over. Take your drink of water. Let’s go. Up! Now!"

And they teased me, unmercifully

They read my signals as time went on. On two occasions when I got stuck, physically unable to move and emotionally spent, each displayed her empathy and respect, then motivated me to move ahead, and I did.

And there was always their therapists’ “rule of two.” No matter what the task, once done, they would reinforce it, allow me to rest briefly, drink some water; and then with withering consistency came the command: “Do it again.” One day, I threw myself out of the wheelchair, got back into it, and grinned triumphantly at having done the task in only six minutes. Time was left; the rule of two was invoked. Fall out again and come in from the other side. Kim and Linda frequently ran overtime with my sessions. I can’t ever remember them stopping early.

Linda’s baby grew, and her belly became the nurturant support for my pathetically weak back. Kim made the move out of her parents’ house and into her own home in Phoenix. And while I learned how to walk and to smile again, my family remained my biggest fans and tried to go about the business of their lives.

Maureen, Beth, and Matthew moved out and on to their schooling. Patty and I celebrated our twenty-seventh anniversary. My mother came to Phoenix and went to the emergency room three times for her own care. My father had colon surgery. Our brother-in-law, Dave Perry, was almost killed during a shoot-out with a survivalist militia member in Colebrook, New Hampshire. Matt Kavanagh called me from Tucson every single night at 7:00 p.m. for a progress report, to gossip about the University of Arizona, or give me an update on Tiger Woods’ latest exploits. Matt and his sister, Mary, visited me three times, kept getting happier and happier to come the more I got better, and did for Patty what all good godfathers should do—be there, no matter what. Patty managed a major reconstruction project, passed an accreditation review and internal audit with flying colors, and gained some weight and a lot of fatigue this summer. My kids started visiting me as a group at the beginning of this ordeal but finished by coming for long one-on-one conversations with their dad in August and September.

More and more of this experience I see through a rear-view mirror. It was the year I planned to throttle down at work, the summer I planned a transition from administration to writing, the fall I eagerly awaited my first sabbatical after twenty-four years of academic life. Instead, Messieurs Guillain and Barré and their 1916 syndrome arrived as uninvited guests. Their presence remains. My feet burn all of the time. My legs feel like two heavy logs. My hands are stiff. My back is always in pain. My lips grow sluggish.

Yet, I will walk out of the hospital on September 15, 1997. On September 21, we will celebrate Pat’s forty-ninth birthday, then begin outpatient therapy the next day. By Thanksgiving, we will have many reasons to be thankful. And on January 1, 1998, I will celebrate my fiftieth birthday. And when I process in academic regalia at the ASU West commencement in December and May, maintaining my unbroken string of attendances at these rites, I will be celebrating the work of new teachers I met, unexpectedly in the summer of 1997, and new learning I found in the most unplanned way. It was a far, far better course that I took, than I ever taught before!

Thank you to the nurses and techs who kept me safe and sane at Thunderbird Samaritan (Lisa, Ginny, Joe, Debra, Carol, Greta, Cathy, Allyson, Sally, Slavica, Ewa, Surinder, and anyone I forgot because of all those days and nights of meds) and at Valley of the Sun (Marg, Vicky, Penny, Kim, Joyce, Ronda, Keith, Alex, Shari L., Marty, Wanda, Belen, Winnie, Alma, Genet, Letitia, James, Roxanne, Amanda, Elizabeth, Sue, Gayle, Susan, Maureen, Dale, Michelle, Chris, Carlene, Farrell, Benny, DeWayne, Shari T., Robert, Laura, Jackie, Bodhan, Cindy, and Gail).

Thank you to the therapists who kept me motivated and became my teachers at Valley of the Sun (Kim, Linda, Amy, Kris, Lonnie, Jackie, Kelly, Dusty, and Peter).

And to the doctors who kept me alive, then intelligent and hopeful (Mark, Robert, Mario, Brendan, Satyavathi, Michael, and Alex).

 Monday, September 15: Day 121

I obtained all of the signatures and went over my “marching orders.” Pat picked me up at 11:30. I said good-bye to Keith, a nurse technician who had been with me since Day 1, and wheeled to the front door.  I stood up, grasped the walker, and shuffled out the door into the heat and light of noonday Phoenix.

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