{Karlton Bontrager}

For weeks Karlton lay bare-chested in the hospital bed. At times we had to put a fan on him to cool him down, but never a blanket to warm him up. Last week, however, he began to complain of being cold. He started wearing T-shirts, but he’d ask to have blankets put on him too. Shortly after we’d covered him up, though, he was hot and wanted all covers–even the sheet–off him. Over and over again he took off his TEDS, the knee-high support hose that prevent deep muscle clotting. But then he began asking to have his socks on again. His temperature fluctuations, we are told, are another symptom of the brain injury. The controls are out of control, and only time will get them to settle back to a normal, more consistent pattern.

His signals for toileting are similarly confused. He often asks for the urinal or the bedpan, only to produce nothing. At other times, he has an accident before he’s had time to ask for help. Last night at tea time (supper) he started in again. He needed to go to the loo. First the nurses brought in a bedside commode. He was unsuccessful there, and got back into bed. The next time, they tried a commode on wheels. We put him on and pushed him into the bathroom, positioning him over a toilet. Then we waited. As he sat there, his attention focused on the other side of the bathroom where there is a sink and a mirror. There, in all his glory, he got his first look at himself in the mirror since the accident. He asked, “Is that what I look like?” I assured him it was, tossling his front shock of hair a bit. He said nothing more.

The move to ISIS has increased Karlton’s confusion. He asks repeatedly for us to take him to his room. And he remembers his 1987 Jetta, asking us to give him the keys to it. Sometimes he asks us to tell her something. Who is he thinking of? Which “her” can it be?

But at least he’s able to rest. This weekend is really the first time since his hospitalization that he hasn’t been poked and prodded continually. The only injections he receives are the anticoagulants that he has to take in the stomach. He’s down to taking only 4 or 5 pills orally. And he has no therapies this weekend. He can sleep as much as and for as long as he needs to.

Yesterday’s Otago Daily Times carried a short article about another snowboarder who suffered a head injury at the same ski field where Karlton’s accident occurred. This was the second such snow sports-related incident here in this region since Karlton’s accident three weeks ago. A friend from Queenstown stopped in to visit him yesterday. She brought with her an article that had appeared in the Queenstown newspaper promoting helmets for snow sports. It included a head photo of the Karlton we all remember. It shows him with an enormous grin.

While he was in ICU, his sisters kept encouraging us to speak Spanish to Karlton so he would not lose those brain connections. The response from the medical staff, however, was consistently that he needed rest, not stimulation. We did use a Spanish phrase now and again, but only occasionally. But lately he has been the one to initiate some Spanish use.

A few days ago, while he was sitting up in bed, he began his insistent pleas to have his head lowered. Typically, when he doesn’t get compliance to an outright request, he turns our questions into an opportunity for persuasion. “Do you like the food we’re giving you?” we might ask. To which he responds, “I’d like it better if you’d lower my head.”
“Is the soup too hot?”
“It’d taste better if you put my bed down.”
And then he surprised us with, “Ayúdame, por favor [Help me, please].”

I can’t recall if I said something first in Spanish or the switch came totally from him yesterday. I was complaining about not having success with using a certain calling card to make telephone calls. He said, “Tengo un número para Usted para escribir [I have a number for you to write down].” And then he recited a pattern of numbers in Spanish. So his Spanish connections are still there in the brain after all.

It’s a beautiful, sun-shiny day here in Dunedin. Choy-Lang and I hope to get Karlton up in a wheelchair to take a short stroll around the ISIS halls today. It may give him a better sense of where he is and help relieve his confusion. I hope your skies are clear and sunny today as well.