Part 2

Culinary skills

Graham helped me pack up my belongings and we were ready to leave. I shuffled along out of the ward to the lift and then to the outside world. We reached home and I faced the same front steps again. Was it only yesterday that I had been normal? Now I was irrevocably changed. Now I was brain damaged. Mentally I was still the same, it was only a physical change that had occurred. But it had happened and I could no longer believe I was invincible. I sat at the kitchen table, in my usual seat and looked around. Everything looked just the same as it always did, completely normal. Only I had changed, or perhaps, just my perception of me. I sat and sat and nothing happened and then I realised that as far as my family was concerned, I still looked perfectly normal. Only I could feel that half of me was missing, and I did not know where it had gone!

It was late enough for tea and still we sat. I suddenly became aware that I was expected to perform my usual task of preparing and cooking dinner, whilst the others watched the six o’clock news. I had managed to shirk my responsibility the night before by having a stroke at teatime. Tonight I could not think of anything else that would out climax that stunt. Grilled steaks, steamed potatoes and pumpkin, some green beans or broccoli, would do for the first course and should be fairly easy to prepare, as I had done it often before. I was able to pull out the various ingredients using my left hand only and filled the saucepan with water, noting that I could not hold the saucepan with my right hand as my hand was too weak.

Cutting the potatoes into serving size pieces was a problem. Peeling them had proved impossible. I could not hold the peeler in my right hand, or in swapping hands, could not hold the potato in my right hand, so it was potatoes in jackets tonight. I held the knife in my left hand and eased it into the right hand, placing the fingers in the correct position, but there was no strength in the fingers and the potato just rolled away. Left-handed cutting was useless, far too dyslexic. So I ended up using both hands to cut, chasing the potato around the chopping board until I could corner it and slice it into pieces. Because I was unable to use my right hand to pick up anything at all, my left hand had plenty to do. It took at least twice as long to carry food, utensils, cutlery and crockery to the table, but at last I was able to announce proudly that dinner was ready.

The same stubbornness that had kept me from requesting help in preparing the meal stayed with me after we had eaten. I piled up the plates and laboriously washed each one in the sink. Trying to hold the mop and clean the dishes required a tremendous effort. It became clear to me that I had to keep watching my right fingers. If I lost sight of them under the water in the sink, or in a cupboard, the fingers would immediately drop whatever they were holding. It was only my constant watching of them that made them work and perform their duty.

Rest assured

After this tremendous performance I was ready for bed. No more encores. I had discovered that I still could get a meal and clean up. I was not completely useless after all. Now if I could just manage the washing, ironing and house cleaning I still had a job as a housewife. Add to that the shopping, the gardening and the babysitting and I would not be a burden to anyone.

My bed looked very inviting so I snuggled into the soft covers. I lay as usual on my right side, but now I could not feel the smoothness of the sheets on my leg, or the soft pressure of the doona touching my right hand. I now had to rely on my left side to tell me where I was in bed. Or how far away or how close to the edge of the bed I lay. I survived the first night without incident, but on subsequent nights I would fall out of the bed and land in a flurry of arms and legs on the floor. Sometimes, it would only take the slightest movement to dislodge my centre of gravity from the edge of the bed to the floor, bringing me with it. Unknowingly in my sleep I had rolled too close to the side of the bed. Other times it was caused by my sitting up too quickly and swinging my legs over the edge of the bed, forgetting in my haste that my right leg could not support me by itself.

One morning, I jumped out of bed, unaware that my right foot was leading, and this limb would make contact with the floor first, but could not hold me up. I started to tilt towards the bedside table, and reached out with my closest hand to break the fall. My delinquent right hand missed the corner of the furniture and I toppled against it, unable to save myself. I had not realized that our new bedroom furniture consisted of so many edges and obtrusions until I landed on each one of them and slid ungracefully onto the floor. It must have been such a comical sight to any eyewitness and just thinking how ridiculous I must have looked, tickled my sense of humour and I burst out laughing. I must keep remembering – slowly, slowly, left foot first. Meanwhile I had a whole new set of technicolour bruises to admire in the mirror, all down my right side. But, looking on the bright side, even if they appeared painful, I could not feel them.

There was another problem in positioning myself comfortably. My right hand kept slipping off the side of the bed, and the weight of this arm, pulling on the shoulder joint and across my back, caused severe pain. I found by keeping the arm wrapped around my body, catching my dead fish hand and tethering it under my left armpit, reduced the disturbed sleep and the dreadful dead weight of my right limb. Was it really twice as heavy as my left arm, or was it my disturbed perception that made it seem so?

One alone

Three days after I came home from the hospital, Graham went up to our house at Warburton for the weekend, leaving Saturday morning and returning home for tea on Sunday night. Alli had also organized to go away at the same time, so I was home alone with just the pets for company. Now I had the opportunity to consider just what had happened and what effects the stroke had on me.

Starting from the top of my head on my right side, numbness replaced all normal feeling on my skin. My upper and lower eyelids were dead, but my right eye was unaffected. My ear was also involved, not only on the outside, but also in the canal, making it very difficult to hear on that side. My cheek and right side of my nose were also ‘missing’ and blowing my nose was a difficult and irritating task. My upper and lower lip, as well as inside my mouth were numb, but not my teeth nor my tongue. I could speak although my speech was sometimes slurred, however, eating or drinking were still precarious actions. I often split my drink as I was not aware if the edge of the cup or glass was actually in contact with my lip or if my fork made it into my mouth or just bumped into my lips. The skin on my face and skull were so sensitive that it was exceedingly painful to comb my hair or wash my face. It felt as if the Novacaine injection had not yet worn off. The remainder of my right side, arm, torso and leg were still numb, but only the dead fish hand and ice block foot felt isolated and separate from the rest of me.

If you can imagine sitting on your foot until it has gone numb, your first reaction is to jump up, start stomping on it to get the circulation going again. The next sensation is of the prickles of pins and needles, followed by the severe pain of muscle cramps, then normal feeling. I was at the numb stage and I hoped I would quickly pass through these other sensations until all was normal.

With Graham and Alli both away on that first Saturday night, I had to cope with being alone and the ‘what ifs?’. It had not been an issue before, being alone in the house at night, but now three days after my Cerebral Vascular Accident, CVA, the medical term for a stroke, it was a different story. What if I had another stroke when I was in bed? How long before I was found and what state would I be in? If I did have another bleed, it would probably be on the left side again, possibly involving loss of speech or ability to communicate to others.

I certainly needed a plan of action. My Girl Guiding days of my youth had taught me to Be Prepared. I decided to take our cordless phone to bed with me, and it could sleep on the pillow beside me, on my left. I also spent some time working out my strategy. If I needed to call 000, I could manage that with my left hand, but if I could not speak, I would need something to alert the operator to the problem I was presented with. I decided to take a chopstick to bed with me as well as the phone. If I tapped dot, dot, dot, dash, dash, dash, dot, dot, dot. Morse code for SOS on the bed head or telephone, it could perhaps be recognized by the operator. So having set all this up I was confident I could help myself in an emergency and prepared myself for sleep. It was a relief to wake up in the morning and realise I had not needed any of the equipment I had so painstakingly gathered.

An incredible exhaustion plagued me. It took all my energy just to get out of bed in the morning and have a shower and get dressed. No matter what I had planned to do that day it had to wait until I had lain down on the bed for a rest. If I did not attend to my body immediately, I would begin to feel lightheaded and anxious. I found it best to respond quickly to my body’s needs and stay horizontal until these feelings passed. The spirit might have been willing and controlling but my body was determined to be heard and not to be pushed beyond its endurance.

One step at a time

Over the next few days I struggled to find a better way of walking, rather than staggering from one piece of furniture to another or leaning on the walls to get my balance. I soon learnt that if I kept my eyes on my right foot and really concentrated my right foot would respond. Heel down first, transfer the body weight on to it, slowly roll onto the ball of the foot and then let the toes touch the floor, gradually moving the weight onto the toes, lift foot and take another step. My leg worked even though I could not feel through this solid block of ice.

It was quite amazing to discover that what had been an automatic movement for almost all of my life, was no longer. Now I really had to concentrate to make the movement happen. Heel then toe, heel then toe. At last I was walking and no longer stumbling. Heel then toe, concentrate, concentrate.

Runners or netball shoes that supported my ankle and foot securely gave me a stable base to walk on. I could not walk barefooted, and needed a thick sole to cushion my foot. Steps and stairs were still a problem. I could not tell how close my right foot was to the edge of the tread, and with no sensation coming from my foot could easily lose my balance. I had to resort to the toddler’s method. Step down with my left foot, bring right foot to the same step then lead again with the left. I was beginning to understand that I needed to relearn all that I had taken for granted. All the automatic movements we no longer need to think about and which become second nature to us had gone. Like a learner driver, her concentration is totally fixed on the road and the mechanics of driving. Once the driver has gained both experience and confidence she can listen to the radio, or carry on a conversation and still be as attentive to the road and the traffic conditions.

It reminded me of when babies were ready to try their hand at walking. They had become experts at the art of crawling, then suddenly something clicked in their brains and they discovered that the soles of their feet were the right shape and form to support their weight and infinitely superior to dragging their chubby little toes along the floor. Being upright gave them a whole new outlook on life. Instead of a vista of floor coverings and other people’s feet, now a larger world opened up before them.

Walking as a skill did not just happen. First there was the frantic totter from the armchair to the coffee table to the outstretched arms of a cheering mum or dad. It was only the momentum that kept them upright and staggering from one foot to the other. Finding their balance and the rhythm of the motion still needed to be learnt. Practice and more practice was required to walk slowly and steadily rather than the frantic rush from one safe refuge to another stable one. This is what I needed to do also. To perform the art of walking and balancing until it either became a natural action or at least it looked as though it was.

Blind sight

I had read Dr Oliver Sacks’, book The Man Who Mistook His Wife For A Hat some years earlier. Dr Sacks is a British born American neurologist who has spent his life working with brain damaged people. I had always been amazed at the various and bizarre malfunctions that had occurred in the brains of his patients and his ability to describe and enlighten the lay person on these conditions. His empathy towards these unfortunate people was great and his enthusiasm in endeavouring to find a solution to their problems inexhaustible.

I found great comfort in his story of Christina, the disembodied lady. Dr. Sacks introduces us to the concept that we have a hidden sense, beyond the normal ones of sight, hearing, touch, smell and taste. This sense is called proprioception and is the ability to recognize our bodies as our own and not someone else’s and to know where they are spatially. The word proprioception is derived from the Latin words meaning one’s own. However, because we rarely ever lose our bodies’ eyesight we tend to dismiss this sense of self as being unimportant. How could we ever imagine that our bodies were not our own or that we did not know where they were?

I can remember looking at each of our grandchildren from their birth on, being amazed as they gradually grew aware of their own bodies. Images of babies lying on the floor, waving their hands in front of their eyes, as if they were unaware if those tiny hands were part of the mobile swinging above them or an extension of themselves. It did not take long before the child not only recognized that this was still her, but that she had control over it and could make it work for her. Cate, at six months knows that her hand can reach out and grab anything to put in her mouth. Discrimination between what is edible and what is not is still a grey area.

‘If I can reach it with my fingers and can put it in my mouth, it must be food!’ so her logic goes.

Looking back, I remember the problems my daughter Fiona had in ballet class. She had grown so rapidly that her arms and legs seemed out of place. It was as if her body image of herself had not grown as quickly. She was still the little girl body inside the tall woman. The little girl shape inside had to grow to fit the new outside – literally growing into one’s own skin.

This hidden sense that Dr Sacks describes, consists of three components. One is our sight, another the organs of balance – the semi-lunar canals found in our middle ear – and thirdly, the sensory perception of the body itself – the body’s own eye. In his story of Christina, she lost all of this sensory perception following a viral infection that affected her spinal cord and brain, leaving her without a body. By carefully watching herself and posturing she managed to carry on with her life, although not a normal life. Every action had to be thought through and then performed. Nothing was natural or automatic. My situation was much less serious than Christina’s. Only my dead fish hand and my ice block foot seemed to have lost their sight and were blind, and I still knew that my right side did indeed belong to me. Although I could not feel any of this delinquent right side, it was part of my body and belonged to nobody else.

Sensational

After a few days I started feeling some sensations over various parts of my body, but they were anything but normal. There seemed to be no order in the way that they occurred or where I was experiencing these new feelings. I found out that they seemed to be random events, rather than a progression of ordered recovery. I would make a report each day to the family as to what was happening, but soon realised that the three weeks recovery time I had been given was very unrealistic. Maybe more damage had been done than we first thought, or perhaps I was just slow.

The first sensations to break through the numbness and deadness I was saddled with were small areas of pins and needles. Then I experienced waves or ripples of pain moving along a limb or torso. Tingling sensations, like tiny electrical discharges appeared and it felt similar to the response on one’s tongue when eating fruit tingles or taking a mouthful of sherbet. I referred to the ants crawling up and down my skin as the creepy crawlies, and fizzing described larger electrical discharges than the tingles, coming from the surface of my skin. More irritating to me were the prickles, as if my skin was in contact with blackberry thorns or was being rubbed with coarse sandpaper. There were strange feelings around the base of a finger or toe, which I called ringbarking, and it felt as if a tight elastic band was constricting the flow of blood to that digit. These developed into large bands, like bandages, tightly squeezing my arm and leg or body. This sensation could last for days at a time, compressing or crushing the limb or torso, and making it hard to breathe as I could not expand my chest.

My right hand felt as if it was enclosed in a very large, very thick leather work glove, and the only feeling I experienced was deep inside the tissues. Harder to bear was the sharp burning response to a light touch on the skin. The knife cut described the sensation when anything touched the palm of my right hand and I felt as if I was being sliced by a sharp blade.

I was determined to work on my right hand and endeavoured to get it to function again. I had almost completed a child’s jumper before the stroke and decided that I would do some rehabilitation on my hand and encourage it to work by doing some knitting to finish the garment. It was hard work to even catch the fingers of my right hand, thread the yarn over my hand and hold the knitting needle in my limp fish appendage. I needed to use my left hand to place the needle in my right hand, folding the fingers one by one into their correct positions. I could not believe that my fingers had no memory of an activity that I had been doing for well over fifty years. Then still using my left hand I draped the wool around my fingers. To knit I had to get my left hand to do all the work, wrapping the thread around the needle, pushing the right hand needle off the left one and transferring the single stitch to the right side. For every stitch I did correctly, I would drop a stitch, or drop the needle, no matter how hard I willed my fingers to work by staring at them intently. It took twenty times longer to knit the last ten centimetres than it had to knit all the rest of the garment. But I did it. I had achieved another goal. In the past I had always used knitting as a relaxing activity. I could watch TV or carry on a conversation and my fingers would still carry out their task. Now it requires my full attention to produce each stitch.

Caged

It was just after my first week at home that I started to suffer from cabin fever. I know I had only been in hospital one day and then back home, but already I felt the walls closing in on me. Just knowing that I could not drive my car or walk outside the house without assistance because I was likely to fall was enough to make me feel trapped. Years earlier on an overseas trip I had talked to many Canadians, and had been utterly amazed by their fortitude. I could identify with the majority of the Canadian psyche, except for this one trait, their ability to cope with the long months of winter and being snowbound.

Up in the Yukon Territory, north of British Columbia, the Top of the World highway runs through the old gold mining town of Dawson City. The locals were a bright and cheerful lot in the summer when I was there. They enjoyed the sunny days and nights as the sun never set. However, how they managed to keep their morale at a high level when for seven months of the year the town is snowed in I will never know.

There is no bridge across the mighty Yukon River joining the two parts of the highway into Alaska. Instead the government ferry freely transports vehicles and pedestrians

from one bank to the other of the fast flowing river. In winter the highway continues uninterrupted across the frozen river of ice to complete its journey to Chicken, Eagle and onto Anchorage. And cabin fever is what those who winter over experience. Days and days of being unable to leave their houses, no sunlight, only darkness and perpetual twilight as the sun never rises. I needed to see faces, places and spaces and Graham’s feeling that it was better for me not to leave the house until I was better only made me feel worse. The local doctor, when I visited him, immediately prescribed for me lots of visitors and all the outings that I could possibly imagine and after following his treatment to the letter the depression began to lift.

Chop Suey

At the beginning of September, my husband and I went out for dinner for my birthday at a local Chinese restaurant. We were asked if we wanted chopsticks with our meal or Western cutlery and decided on the chopsticks. This was another challenge for me.

Could I actually hold the chopsticks in my damaged hand and control their movements? I started to practice with the prawn crackers on our table and at first it was a complete disaster. I needed my left hand to hold the right hand fingers over the chopsticks and then trying to make them open and close and not drop the food was rather difficult.

However, by the time we had completed the meal the hand was functioning very well and I was not too clumsy. In fact, because the food was all bite size, it was of no account that my right hand was too weak to use a knife to cut food. Perhaps all my knitting exercises had helped towards this newly returned skill.

To rehab or not to rehab?

After a visit to my local doctor, he agreed that I could benefit from physiotherapy and occupational therapy so he wrote me a referral to attend the local Rehabilitation Hospital. I had already been on the telephone without success to find a physiotherapist who would work with me. I had never realised there were so many specialized areas in physiotherapy and what I required was a neurological physiotherapist.

Years earlier I had experience with the Feldenkrais technique and knew this would be suitable for me. However, I was unable to find a practitioner of this technique in walking distance. After the surgery on my neck in 1991, for the removal of a disc that had ruptured and was pressing onto my spinal cord and a repair on my left knee for a torn cartilage I required some physiotherapy. I was fortunate to have found a physiotherapist who was a qualified Feldenkrais practioner. She described to me that in this technique, named for its inventor, gentle exercises are given to the unaffected side of stroke survivors.

Instead of just reaching for an object, which is a normal automatic action, one had to consider each individual movement. Which muscles were required to carry out the set task, breaking down complex movements into single components. Once the breakdown of individual events was learnt, the exercise was repeated on the damaged side with very good results. There was evidence of the brain’s ability to re-assign the role of the damaged section, to other parts of the brain, albeit not as efficiently as the original area. Although I had not had a stroke then, I was experiencing a lot of post-operative pain, not only from my neck and my knee, but also from complications after a hysterectomy six months earlier. In an effort to control the pain, I had successfully tuned out my left side so it no longer existed in my mind and I had no sense of it.

I knew that the local Rehabilitation Hospital certainly worked with stroke survivors and I was anxious to start. It was not easy joining there as an outpatient. My father, on the other hand, at ninety-one years of age, had been transferred there, five days after he had a stroke, from the acute hospital, and four weeks later was as good as new.

First I had to be assessed by the rehabilitation doctor and declared that I would benefit from the processes, then my private hospital insurance company had to approve the rehabilitation. Next came the assessment of my deficits by the physiotherapist and occupational therapist and at last I was given an appointment to attend my first session – four weeks after the stroke. I was allowed two hours of physiotherapy and two hours of occupational therapy each week, and it was impressed upon me the importance of practicing my exercises at home each day to obtain the best results from the therapy.

Sue, the physiotherapist, a cheery and bright-faced young woman, introduced me to the various pieces of equipment. Her brief was to increase my stamina so that I could better manage the affected weak right side. We went through the sequence of the step machine, pushing my feet against a resistance, and the treadmill where I was attached to the machine with a safety belt, in case I fell. Other pieces of equipment included the exercise bike, and the coffee grinder – a pedaling machine for increasing strength in the upper arms – a small flight of steps to climb up and down and a set of rocker boards. These are just a simple board with a block attached to the underside at its centre. One stands on it, one foot on each side and pushes down, alternating sides. Even though I could not feel my right foot and ankle doing any work at all, Sue was pleased that all my muscles and tendons were functioning normally. Then I was left on my own to do this circuit of exercises while she worked on her other clients.

The gym area at the hospital was decorated in green and gold balloons and banners as we had but a few days to go until the Olympic Games opening ceremony. I decided that I would award myself with a gold medal for my efforts and made a point that each session I attended I would exceed my personal best performance by at least twenty-five percent.

House of horrors

The occupational therapist was in charge of all other rehabilitation. Her brief was to allow me to achieve a normal as possible life style with the emphasis on functioning and the process of living. It was fascinating to see such a large and varied amount of equipment in this department. One room was set up as an operative kitchen, complete with microwave, sink, stove and refrigerator. I easily passed the test on making coffee for Barbara, the OT, and myself. I remembered to use my left hand for lifting hot or heavy utensils, but both hands to do the washing and the drying up.

We practiced pegging clothes on a clothes line, folding and unfolding towels, and discussed ways to make life safer and tasks easier in the home. Barb mentioned being efficient in the home and thinking ahead. But with five children to bring up, I already knew how to conserve energy and still finish the chores. I already had organized my kitchen to make the most use of the furniture and layout and to minimize extra walking.

The next room was lined with shelves full of instruments of torture. There were bolts to be unscrewed on pieces of timber, and then to screw back up, buttons to pick up and beads to sort and thread. The one exercise I dreaded most was the one that inflicted the worst pain. I had to put my right hand into a bowl of raw rice, and wriggle it around until I could find and draw out small objects hidden in its depths. The pain generated by every small grain of rice touching my hand and wrist was excruciating and I always hurried to finish this one and get it out of the way.

I was left on my own to carry out these tasks as Barb had another client to attend to at my appointed time. She would show me what I had to do and then she would disappear into the next room. Once I had finished the set task I was to knock on the door and she would return to me and give me another exercise to challenge my abilities. I felt very uneasy at interrupting another person’s important rehabilitation time and would continue to repeat each exercise over and over until Barb had time to return to me.

Another exercise involved a bowl filled with hot water and another with cold water. I had to plunge my right hand first into one and then the other to assault the senses. After this came the soothing part, my hand and arm were massaged before being rubbed down with a coarse towel. Everything was done to stimulate the nerves and bring their responses back to normal.

It quickly became apparent to me that I needed not only to be my own coach and steer a path of recovery for myself, but also to be my own cheerleader. I had to continue to be enthusiastic and positive and celebrate each milestone on the way. As I looked normal and could walk no one was aware of any of my deficits. Sensory perception cannot be seen, only felt. The loss of proprioception was mine alone. Lack of the ability to discern textures and temperatures of any objects was clearly only my problem. It was certainly not discernible to those around me. Pain is also invisible to those not experiencing it.

I had discovered at home the need to massage my arm and leg, and went through many jars of moisturiser. The whole of my right side was peeling and the skin was very dry. Barbara explained that this was a normal condition. The brain in endeavouring to recover and heal itself from the effects of the stroke, takes all available nutrients to do its job. So every day I would spend time revitalizing this side.

At the rehabilitation centre there was a large wooden solitaire game on the wall and I always took time to see if I could solve it in as short a time as possible. At home I made my own game using small lids as counters and practiced using thumb and first finger for the first game, thumb and second finger for the second and so on, trying to get the fingers to function. Concentrating on my moves rather than my fingers distracted me from the pain. I worked as hard as I was able to at each session to learn and experience all that I could.

After six visits of Physiotherapy and Occupational Therapy I was told I only needed to come once a week from now on. The rehabilitation team had reassessed my need for Physio and OT. I was unsure whether this meant that I was doing very well, or that I was not working hard enough.

The Physiotherapy and OT departments were safe and secure places to be in. There was no danger of being knocked over, or tripped up due to uneven floor surfaces and the staff were aware of our disabilities. All the clients supported each other when we achieved our goals. The mere fact that we were there meant that we had a need to recover either lost movement, sensation or abilities. Many of my fellow workers had knee reconstructions, or were recovering from car accidents. In the OT department, I met other stroke survivors and we were all interested in each other’s progress. We were all working so hard and concentrating on the task set in front of us, that it was difficult to find time to speak to each other. However, much could be conveyed by a smile or an encouraging look.

On my ninth and last visit, I could walk two kilometres in twenty minutes on the treadmill, and had increased both resistance and time on the other pieces of equipment in the physio department. I could manage the flight of stairs down to the OT without holding onto the rail and using only one foot per step all the way down. I had managed to perform intricate tasks with the fingers on my right hand, but on that final day still failed every test on discrimination of sensations.

Hot was cold, cold was burning, sharp was blunt, blunt was also blunt, soft was hard and felt the same as hard, smooth was rough, light touch was painful, firm touch normal. So long as I could see my fingers I could manage to do most things. However, I failed all tests when my hand was hidden from me. One exercise was to identify objects and textures when they were placed one at a time in my hand. As I had no feeling in the palm of my hand I was unaware when an article was actually given to me, let alone identify what it was.

Water torture

As part of my rehabilitation, it was suggested that I would benefit from one hour of hydrotherapy, along with the physiotherapy and occupational therapy. I arrived at the pool on the first day, unsure of what was ahead of me and how it would go. The thought of working at exercises in a warm pool produced pleasant images and I was certain that I could manage all the activities with ease.

The physiotherapists in charge of the group were highly organized. We all lined up at the edge of the pool and one by one were assisted down the steps and into the chest high water. My first exercise was to walk slowly down the length of the pool and back again. As I proceeded to carry this out I found it was far more difficult than I had first realised. I was supposed to keep my eyes straight ahead, but without looking at my right foot, it would not perform. Also as the floor of the pool sloped down, I became unbalanced and kept falling over.

The pressure of the water on my super-sensitized right side was agonizing. I felt I was being crushed and squeezed. I could not believe how heavy the water was and how hard it could push. My expectations of gentle lapping water holding me and supporting me quickly evaporated. Here I found the water did not assist in helping me move, but rather restricted me and held me back. As a force of resistance it amazed me. Images of floating, relaxing and letting go disappeared as I found in the water an enemy and not a friend. This foe restricted and prevented my movements, forcing me to conform to its shape. The warm friendly embrace had turned into a crushing bear hug, pinning me down and constraining me.

We had to walk around in circles, trying to stand on one leg at the same time as catching a ball and all the time my right side was screaming and screaming with pain. What I thought would be a relaxing and refreshing interlude became a nightmare, with the physiotherapist berating me for my poor performance. It did not seem to help by trying to explain exactly what was happening to my injured right side. I looked alright and only I could feel the pain.

The hour stretched on and on and it was a relief when at last the session was over and we could climb out of the pool. Fortunately for me I developed a cold by the next appointment and by the time I had recovered from it, I had convinced the physiotherapists that hydrotherapy was not for me. It has taken me many months to be brave enough to try entering a swimming pool again or even to lie down in six inches of bath water.

Wet and wild

Early on in my recovery, a friend suggested that a warm bath would be beneficial as it would relax all my muscles and release the tension in my body. I decided to give it a go. I had been managing to shower myself each day, although it was still an exhausting and slow business and I needed to have a rest after such strenuous exercising. The concentration required to follow out each planned movement quickly drained me of energy.

I ran the bath and tested the warm water with my left hand. I was well trained by now and rarely ever burnt my right hand. I disrobed and stepped into the bath, first one foot and then the other, and then... what came next? I stood and stood and thought and thought, but I could not discover a way to lie down in the bath from a standing position. All the intervening steps were missing! Unless I could see my right side it did not exist and therefore I could not fathom how to bend and lower myself into the warm inviting water. I stood and stood. The water lapping around my ankles changed from pleasant warm to irritating cool and I still could not work out the processes. As the water became colder, I gave up and had a shower instead.

After I was dressed, I decided this would not beat me. I stood in the centre of our lounge room and endeavoured to lie down on the floor. I managed to get down on my hands and knees and then roll over onto my back. To rise up I needed to repeat the process backwards. Roll over onto my hands and knees and then pull myself up again. It took much more room to execute these actions than was available in our bath so I did not repeat the process.

Months later I have realised that there is another way and another word – crouch. That was it. That was what I could not remember. Neither the word, nor the action. All my life I have climbed into the bath, stepped, then crouched, then lay down, but for nearly twelve months this process did not exist in my mind or my memory.

Now I can celebrate that another missing piece has returned. It is very easy to know what I know and not so easy to know what I don’t know, but when it comes to not knowing what I know, how can I access this missing knowledge?