This is an account of my father’s dreadful head injury which happened on May 10, 2005. I finally got around to writing up the notes…
At quarter to five on a Monday afternoon I received a call from my mother telling me my father had fallen off a ladder and suffered a head injury. She was unsure exactly how severe it was, but he was “in a pretty bad way.” I ran out of my flat and took a taxi across town through peak-hour traffic, thinking how ironic it was that only moments before I’d been dozing at my desk, conjuring excuses not to go to university that evening.
When I arrived at Emergency at St Vincent’s Hospital, Darlinghurst, I had no reason to suspect it would become so familiar to me. I found my mother in a small waiting room beside reception, drinking a cup of tea and looking composed but bewildered.
“Oh, Benjamin,” said my mother. “Thank god you’re here.”
Before I’d had a chance to say boo to her, a social worker introduced herself as Julie and asked if I too would like a cup of tea. I said I would, then turned to my mother.
“Your father was fixing the awning and he fell off the ladder. The lady who lives upstairs over the road saw him and called the ambulance.”
“But how bad is it?”
“Oh, he looks awful.”
“But how had is it?”
“I don’t know. They haven’t told me yet.”
Very little news had come through and, this, coupled with the shock, made it difficult to feel properly panicked or upset. I still felt a lingering air of inconvenience. How bad was it, for goodness’ sake?
Over the ensuing two hours our fears increased significantly as we learned more about the damage to my father’s head. On the surface there was a fracture at the back of the skull after a direct impact from a fall of between two and four metres, plus his two remaining front teeth had been knocked out. His neck and back were also uninjured, badly bruised and grazed, yet our biggest concern was about the state of his brain.
At last we had a visit from a young English doctor who told us how things stood.
“It’s a very serious injury,” he said. “To be perfectly honest, we can’t give you any guarantees at this stage. The next forty-eight hours are crucial. With an impact like that the brain can swell up so much it can cause a haemorrhage or stroke by pressing too hard against the casing as it expands. We just have to hope the swelling isn’t so bad. It’s a wait and see situation. There’s not a lot we can do.”
My mother clasped my hands and gasped back her tears. She was too thankful with the doctor, embarrassed by her own emotion. The doctor was handsome and kind and she wanted him to know he was a good man.
Shortly afterwards we were joined by my older, half-brother Dirk.
“What’s he done this time?” asked Dirk. “He just wants to be the centre of attention!”
I felt reassured once Dirk was there; with the news growing darker, numbers would help to shore us up against despair. Julie brought more tea and sandwiches and offered more comforting words. I soon began to feel sorry for her, coming face to face daily with others’ tragedies.
At seven-thirty we received word that we could see my father and we kicked immediately into gear. Julie led us via the spacious lifts to the Intensive Care Unit on level five. We emerged into a wide, hundred-foot long, linoleum-paved corridor. A garish series of canvasses stretched along its length. It was my first taste of a place that would become indelibly familiar to me over the next week.
We were led straight to the I. C. U. waiting room where we were introduced to the neurologist, Surita. She had conducted the first C.T. scan.
“There is a lot of bruising and swelling of the brain,” she said. “And until the swelling stops there is a very real risk of haemorrhage.”
It was the same news; she could tell us nothing different. Having already plumbed the depths of the worst-case scenarios, there was little left to be shocked about. The English doctor we had met before, whose name was Kevin, rejoined us. He was in a chirpy, sympathetic mood and he cheered my mother up no end. Ironically, that afternoon my parents had arranged to meet and see the film Downfall. Kevin jokingly suggested that since my mother was now without a date, he ought to take her himself.
It was another half hour before we were admitted to the Intensive Care Unit. We walked through in silent anticipation and reverence. There was activity all around, but I was compelled to focus only on my father. There he was, laid out, bloated and bloodied. At first I struggled for equanimity against the sight of his breathing tube and the small pool of vibrating blood caught in its corrugated U-bend. In the thin line draining fluid from his lungs via his nose, pockets of bile shunted down towards a bag remaining mercifully hidden. I was saved by the whiff of hospital fluids, a tusk of alcohol riding the bestial emissions of bodies in crisis. I feared that I too, like my brother Matthew, might be prone to blood injury phobia; a mix of anxiety and disgust leading to a sudden loss of blood pressure which had caused him recently to faint and suffer a severe concussion upon a visit to see his girlfriend in hospital. I gripped the railing of my father’s bed and smiled with false courage.
My father was battered, damaged, hanging in the teeth of death. Yet he was also a tough old bastard and if anyone could keep themselves alive through sheer bloody-mindedness it was him. He was in an induced coma, to stop him struggling against the bonds. Apparently he had wrestled with the paramedics, ordered them from the house in a stream of filthy insults. It was incalculably fortunate that our neighbour had seen him. In the aftermath of his fall he had lain like a felled giant, flat on the bricks gushing blood. Yet still he had regained his consciousness, crawled to the kitchen, dragged himself to his feet and carried himself off to bed. He would have died there had he remained undiscovered; drowning in his own fluids as his gums poured blood into his lungs. I surmised that, in landing, his arm had swung back and through his teeth; what appeared by comparison a minor, cosmetic injury, might have been the final straw in this calamity. We stood and watched him a while, taking turns holding his hands and whispering words of encouragement, inaudible to him, but reassuring for us. We would need to maintain high morale for there was little chance this would be over in a hurry.
That night, I went home to my parents’ house with my mother and from there I immediately phoned my oldest friend Gus. He had done his PhD in traumatic brain injuries and would be able to tell me everything I needed to know.
“If it’s as bad as you say,” said Gus, “then he’s going to be out of action for a long time.”
“Months. Maybe three or four months to recover. It all hinges, of course, on how bad the damage is and how long the post-traumatic amnesia lasts. Post-traumatic amnesia effects the ability to form new memories. He’ll be able to remember the past, but it’ll be almost impossible to form new memories in the present. For a while anyway.”
“That’s the thing; it’s hard to be sure. The length of the PTA usually determines the extent of permanent brain damage. If it lasts a few days, he’ll probably be OK. If it lasts a week, then there will likely be more damage. If it lasts two weeks, three weeks, a month or so, then it often indicates quite severe cognitive impairment. It’s not a fixed scale, there are a lot of variables, but it’s a general rule that the length of PTA coincides with the level of damage.”
I talked to Gus for over an hour, quizzing him on every possibility. The staff at the hospital had told us none of this, focussing instead only on his immediate situation. It was a relief to know, but also difficult to stomach the idea that he wasn’t going to walk out of hospital in a week with some bruises and a headache. From what Gus had told me, he was likely to be there for two weeks at least, before undergoing extensive rehabilitation in a dedicated rehabilitation centre, to assist in restoring his cognitive ability. This was going to be a long campaign. I hung up the phone and broke the news to my mother.
It had become abundantly clear that we had on our hands a family crisis of the first magnitude. The following morning, on the way to hospital, I phoned work and took the rest of the week off, condemning myself to impending penury. Going back and forth to the hospital every day was hardly my first choice for a holiday. The idea of sitting and fretting on the purple chairs in the fluorescent mint waiting room of I.C.U for an indeterminate number of future days was not so much scraping the barrel as eating the bottom out of it so far as vacations went.
I must have looked anxious on that second morning, for the bearded, weather-beaten man sitting opposite, waiting for news of his brother, looked up from the Daily Telegraph and said:
“Don’t worry, mate. This place is like Valhalla. Everyone here’s a bloody hero.”
I chuckled and thanked him, feeling one of those fluctuating mood spikes so common to crises. From what I had experienced so far, I found little reason to doubt his words. The staff weren’t exactly wearing horned helmets, sporting battle-axes and quaffing foaming tankards, but even in the few brief encounters so far, it was clear that they were all heroes dedicated to the point of obsession. Irrespective of their medical expertise, having always been particularly squeamish, I was impressed merely by their willingness to deal with the array of revolting discharges with which they were regularly confronted. As I stood beside my father that morning, the man in the bed opposite continually groaned and vomited, shouting in despair for the assistance that was never absent. Elsewhere a man was swearing aloud after having soiled his bed. Across the room I could not avoid catching glimpses of the stricken; mostly elderly people, propped in often necessarily undignified positions, plugged into a tangle of tubes.
That morning I met Som, an amiable Thai nurse with a comforting smile. He had been assigned to my father and, over the next few days, he became our first port of call.
“Your father very strong,” he said, smiling. “Already he try to get up when he wake up one time. They want to keep him under sedation for at least two more days.”
Som struck me as a man who found it easy to be gentle. One minute he was hushed, addressing us with a touch of his soft hands, then his eyes would gleam with conspiratorial humour, as coy as a teenage girl. I was impressed by how personable all the doctors and nurses were, recalling public concerns about medical staff who lacked communication skills and empathy. Anna, Nicola, Jenny, Brian, Eric, all of whom had found the time to be pleasant and show genuine sympathy, even early in the morning or towards the end of twelve-hour shifts. They were comfortingly frank and honestly optimistic.
Outside in the waiting room, an altogether different culture was taking shape. This space soon became a meeting place for my father’s journalist colleagues and friends. I witnessed tears and laughter, black humour abounded, and within a few days the burden of co-ordinating everyone was transformed into an obsession. I began to feel almost at home when in this space, with its unforgiving lighting and repellently “neutral” scheme. It warmed considerably once colonised by passionate well-wishers. I felt a peculiar satisfaction in being the go-to man for news to some of Sydney’s best journos; presiding over the space and ready, at the drop of a hat, to deliver the much-rehearsed verbal press release.
By the third day, my father had survived the immediate risk of haemorrhage, but he was by no means safe. The doctors were still reluctant to be confident and chose to keep him in a comatose state so that his body might recover without the stress of consciousness and physical restlessness. After these first three seemingly eternal days, the hospital visits had already become routine. Going to and from St Vincent’s up to three times daily slowed down the passing of time by breaking the day into many different units; the heightened emotions added a raw edge that cast this environment more distinctly in black and white. Considering that I was, in effect, on holiday, I brought my camera and took photos of the people and the scenery.
The fine mildness of the dry May air was spiced with a pinch of desiccated leaf, and the occasional curlicue of chilled exhaust. The pale, cream hospital, bathed in crisp light and stark against the cloudless blue, radiated confident functionality. On the curving wall of the car-park entrance ambitious creepers pressed themselves arrestingly flat against the paint. By the sliding doors, invalids stood smoking by the drips they had dragged with them on wheeled stands. I found their relentless determination to get straight back into being themselves encouraging and amused myself with the thought that my father, being no idler in the assertive personality stakes, would be ordering everybody about again in no time. Despite his being such a difficult person, we only wanted him to be himself again as soon as possible.
Through the glass doors was an oddly welcoming world: purple carpet flecked with slashes of primary, a black wall embedded with backlit glass vessels, a collage of shots exhibiting local colour, monochrome photographs of a rodeo and a polished wood-veneer reception desk that everyone seemed to ignore. There was bustle about the café, tired faces of relatives, more ambling patients, a charity stand and industrial vacuum cleaner, and striding through everything with unaffected nonchalance, the doctors and nurses who had seen it all so many times before.
Having awoken to the possible consequences of the accident and the responsibility it entailed, these small details became comforting when appreciated in their own right. Optimism was a necessity and I began to view the journey as a quest for small positives alongside an indeterminately long road. My mother equally sought refuge in small mercies, and came to focus her attention on visits to the hospital café. “You must try one of these flans,” she enthused to me one afternoon. “They’re to die for.” As is so often the case with her, it was not long before she was on friendly terms with all the staff and receiving freebies.
Inside the I.C.U., Som remained our principal contact. He was always cheery and mild.
“Your father is very strong man,” said Som one afternoon, tittering. “All the time he try to break free. Even, unconscious, always, his body want to get up. Like Frankenstein.” He held his arms out and walked forward slowly, then began to giggle, his shoulders shaking amidst piping sibilations. His warmth was catching and we laughed along with him.
“We have to keep him tie up. Until he go off the drip.”
Like so much that is said in hospitals, it was both comforting and disquieting. We were concerned that my father might think he had gone mad should he wake up and find himself restrained. He had often joked that if he went “silly in the head” I was to finish him off with the two-pound hammer. Part of me genuinely feared that he might well have suffered irreparable brain damage and would never function normally again. I tried to focus instead on wondering whether or not he was dreaming.
On the fourth day, the breathing tube was removed and my father was allowed to emerge from sedation. Som was overjoyed when he saw my mother and I approaching the bed.
“Come see, he talking now,” said Som, beckoning us.
My father looked awful, swollen and bloated and sick. His face was bruised and veined by broken vessels. When first he spoke his voice was nasal and windy, transformed by the loss of his front teeth. It rasped like grinding gears, punctuated by coughs and gurgles.
“G’day, son. When did you arrive?” His eyes were bleary, yet his eyebrows attempted surprised inquisitiveness.
“I’ve got to get back to the hotel,” he said. “I’ve got to make some phone calls.”
He ignored my question.
“Where are you staying, mate? Which hotel?”
“He must think he’s still in Bali,” said my mother.
“You’re in Sydney,” we both said to him.
He looked at me like a dog shown a card trick.
“Sydney, we’re in Sydney,” I repeated.
“When did you arrive? Are you going back tomorrow?”
His eyes glassed over and he sank back into his pillow.
As Gus had informed me, Post-Traumatic Amnesia, an almost inevitable consequence of any serious brain injury, impairs the ability to form new or continuous memories. It does not normally affect memories formed before the injury, although recollections of events immediately preceding the accident might vanish, sometimes for good. In my father’s case, he appeared to have lost at least five days. He had returned from Indonesia on the morning of the Friday previous, where he had been breaking stories on the 2005 tsunami and the Bali 9 heroin smugglers. He did not realise he had left.
A few minutes later he opened his eyes again and peered through a milky film.
“Ah, g’day, son,” he said. “You’re here as well? Everyone must’ve come over.”
There was a stab of shock at his forgetfulness. It was to be some time before we became used to it.
“This is Sydney,” I repeated. “Sydney.”
“What? I can’t hear you. Which hotel are you at?”
They tested his hearing that afternoon and got no response from one ear and virtually none from the other. We later learned that his left inner ear had been fractured irreparably in the fall and his right ear, which had previously been his bad ear, only had about twenty percent hearing. My mother and I went immediately and bought two foolscap notepads and a Texta.
Thus began our hapless attempts to communicate with him that were to improve only marginally over the coming months. My father would ask a question, almost invariably something to do with our whereabouts, and by the time we had written the answer, he had forgotten not only the question, but the fact that we were there altogether.
“Ah, g’day, son, good to see you,” he would say, as I sat scrawling an answer.
No matter how often we wrote to tell him that he was in Sydney and not Denpasar, it never registered for more than a minute or two. It was like talking to a deaf goldfish. His lapses in memory could be at times shockingly demoralising and at others, cause for amusement.
After six days my father was moved from I.C.U. to the Neurological ward, where, in his bed on level seven, he could see the city skyline. This helped to convince him that he was no longer in Bali, but only for brief periods. Even though he could see Centrepoint Tower, it still had to be pointed out to him and the import of its being there made clear. In the new ward, we found a wholly different culture with a host of different faces. Everyone moved at a slower pace compared to the decisive energy so prevalent in I.C.U. During his first week there, my father was in and out of a host of rooms, which didn’t help to anchor him in the present.
“Good to see you, son! Where are you staying? Did you fly in today?”
Now that he was more animated, it became increasingly exhausting spending time with him. The shifts at work I had felt so relieved to discard would have been preferable to the draining routine that replaced them. Since my father seemed to think he was in Bali, I began to daydream about being there. Sitting in the ward room with the blinds drawn on account of his headaches, I conjured pristine beaches attended by fawning palms. The tropics had always held a false lure for me, as someone more at home with museum collections or the dusty foundations of an ancient structure. Just at this moment, however, I would have given anything to be sunning myself on the beach, amongst the splashes, boasts and giggles of the Balinese meat-market.
After two weeks the post-traumatic amnesia did not appear to be lessening. It would have been a lot easier to deal with were it not for his deafness. My father began to ask more complicated questions. He was gradually becoming paranoid; unable to work out quite where he was or why he was there, his journalist’s nose for conspiracy led him to question everything. The problem remained that, by the time we’d written the answer, the question had slipped from his mind. I could see the fear in his eyes. It was an awful look of confusion, of a longing for trust founded on a dreadful mistrust. He was not eating and had, in just two weeks, shed almost ten kilograms. He looked taller, more angular, more fragile.
Throughout my life my father had always been an alpha male of the first order; a moustachioed masculine figure; a sailor, a sportsman, a marathon runner, gun journalist, a fighter. He was famously brave and famously good at what he did, undaunted by getting himself smuggled into Afghanistan in 1981 to join the Mujah Hideen who were then fighting against the Russians; spending months in Lebanon during the war with Israel and bringing home the bullets plucked from a wall that had nearly killed him several times; crewing boats that sailed around Cape Horn and the Cape of Good Hope. Occasionally he was wracked by nightmares of helicopter gunships, of religious fanatics who had tried to kill him for something as innocent as bathing naked in a stream. He was highly strung and unpredictable; at times irrational and angry, he took things out on his family, who were not especially forgiving. His real weakness was alcohol, yet it only made him more macho, and as a child, I’d hidden away from him; more afraid of him than reverent. I grew up spending the bulk of my time with my mother, whilst my father was on assignments, or in the pub. I was far more inclined to her habits – quiet pursuits like reading and writing – and found his machismo and jingoism disappointingly vulgar; until, that is, I began to affect it at the age of 16.
Now, weakened, restrained and bewildered, his eyes had the awful sadness of a caged, emasculated lion. He had become dependent on others, a situation that was initially unbearable for him. As I sat there, day after day, observing him and attempting to communicate with the notepad and gestures, I felt a great upwelling of annoyance at the stubbornness that had led to all this. That he had fallen off the ladder whilst fixing the awning in the backyard was the final consequence of his twenty-year effort to redecorate the house in Centennial Park.
From 1985 onwards, the family home had been a semi-construction site. My father had taken on almost all the tasks himself with the reluctant aid of his sons. For years, instead of being able to spend time with friends or play games with my brother, I had been handed a shovel or a paintbrush or a bucket on a Saturday or Sunday morning and made to work. I dreaded going under the house, where, cramped and wearing bicycle helmets, we shovelled out mud and dug channels and rubble drains in an attempt to stop the rising damp. Sure, he paid us generously, but at the age of thirteen I had no interest whatever in anything physical. Even later, once I’d started playing rugby, I resented this never-ending family obligation to work on the house. I hated it, and I hated the incompetence with which so much of the work was done. Three or four years after something was finished, the cracks began to appear. The mistakes were often very costly and, ultimately, it would have been far cheaper to have the whole house overhauled in a few months before we moved in. Had my father not insisted on torturing us all with his personal project for years – and my mother certainly had plenty to say about it, largely unheeded – then our family life might have proven far more harmonious. Had my father not tortured himself with his own project for twenty years, he might have instead spent his spare time finishing his third novel, then writing a fourth and a fifth and so on. Instead, he stalled, devoting himself to physical labour that only seemed to make him more annoyed, and indeed, more annoying. In the end, it led to his loss of a finger, when he dropped a great block of sandstone on it, and finally, this horrific accident.
I sat in the hospital and watched him for hours, laid up and afraid, stripped of his tyrants’ crown, yet still no less demanding. After two weeks he was moved to the Brain Injury Unit of the Ryde Rehabilitation Centre where he was to spend the next three months. Even after six weeks, he still suffered from post-traumatic amnesia, but it had gradually begun to lessen. It became possible to have conversations with him, albeit through the medium of the notepad and pen. These conversations mostly consisted of mundane small-talk, yet he also wanted to be informed of developments in stories he had been chasing in Indonesia. As time passed, he became increasingly paranoid, afraid that he was trapped in some sort of conspiracy. Story elements, jostling about in his imagination, began to creep into his utterances.
“Listen, son,” said my dad, grabbing me by the forearm one day. “I’m telling you right here and now, don’t get involved in buying those plane tickets from the Russians. They know all about it in New York. It’s too dangerous. I don’t care how bloody cheap it is, don’t buy those tickets from the Russians!”
On several occasions he would point to the notepads on which we wrote and demand that we keep them safe.
“Don’t let anyone see your notes! Keep them with you at all times. When you go, mate, you should take them with you. A journalist always protects his sources,” he said, banging a fist. “It’s not safe leaving them here; there’s people coming and going all the time. I don’t know who the fuck half of them are!”
After two months, they let me take him out to Camperdown to meet with a specialist doctor who performed Cochlear implant operations. We were relieved to find, when tested, that the nerves attached to his shattered inner ear were still intact, allowing him to have a bionic implant. A week later, the operation took place and, with the aid of a hearing aid on his other ear, we were at last able to hold a conversation with him in real time. I cannot even begin to express the relief that this caused, despite the fact that his comprehension was awfully patchy as he got used to the sounds through the devices.
“Mate, you sound like bloody Donald Duck. What’s the story? Stop quacking.”
On visits I would find him shuffling about the rehabilitation unit, wobbly and weakened, yet too curious and bored to stay in bed all day. Despite the bouts of paranoia, he was friendly with most of the staff; he seemed to have acquired more patience than I’d ever thought him capable of.
After three and a half months they finally released him. My mother felt a contrasting mix of relief that she no longer had to venture out to Ryde on a daily basis, and annoyance that my father was coming home where she would have little respite from him. Remarkably, despite the length and severity of his post-traumatic amnesia, despite the savagery of the injury he had suffered, my father’s brain had undergone an extraordinary rehabilitation. No doubt in part due to his strength of personality and fierce determination, his brain had re-routed much of its processing via less damaged regions. It seemed the principal impairment was with the bigger picture; he found it less easy to comprehend larger narratives, such as the complexities of a plot, yet he was by no means unable to do so.
On the whole, he was still very much himself. Indeed, in many ways, he seemed a taller, ganglier, more softly spoken version of the same man; a little more fixed in his inflexibilities, more prone to perseveration, but at the same time, slightly more apologetic. Having been brought so low, having for months relied entirely upon nursing staff and his family, and having finally understood how much effort people had put into his recovery and how dedicated his friends and family had been in following and assisting in his progress, almost none of which he would ever recall because the memories had never formed, he seemed quietly thankful.
My mother and I were also quietly thankful, though often we glanced at each other with the exhausted look of the long suffering. The power vacuum had brought about a coup, and the family dynamic would never be the same again. The totalitarian dictatorship of the Workers’ Socialist Democratic Republic Paradise, as my father called the house, had become, at last, through crisis, a genuine democracy.