Showing posts with label traumatic brain injury. Show all posts
Showing posts with label traumatic brain injury. Show all posts

Saturday, April 12, 2014

Eulogy for George

George Cadman Wilson, July 11, 1927 - February 11, 2014

Thank you, so many, for sharing your love and memories of George.

Dad was an immense man, a man in full, who touched many people, and impacted the course of important human events – He helped end wars.

I am going to focus on one part of George that you may not know much about, because George was very private with his inner self.

George Cadman Wilson was the strongest man I ever knew.

He schlepped and lugged a rifle, armor, and backpack among Mud Soldiers in Vietnam. There he found great dignity, integrity, and selflessness – and, yes, humor.

At age 75, Dad enlisted as an embedded correspondent in the Iraq War drive to Baghdad. The young soldiers asked and thought, “Hey, how old are you? You must be at least 50.”

Dad had two major heart surgeries, in 1979 and about 1995. Dad was diagnosed with myelodysplastic syndrome in 2001; this is sometimes caused by Agent Orange used in Vietnam … MDS kills most people in 6-7 years … Dad sailed past that.

Last March 2013, George and I went to Los Cabos, Mexico. He met an attractive 40-something journalist from Canada, and joined her for a trip to a fishing camp up north … His parting words were, “Jim, I’ll meet you at the airport Saturday.” There was a raw strength and masculinity to George.

He also had the strength to be sensitive, to cry and feel other’s pain. He certainly did this for me as I struggled from deep coma and traumatic brain injury for 35 dark days in 1977, and for many years beyond. In January, when we had an important family matter, apart from Dad’s cancer, Dad wrapped me in his arms and fought to find reason with life’s events, and we sobbed together.

The comfort George has given others is greater than any I have known or seen.

On Tuesday, February 11, two days after visiting with dear friends here with us today, Dad could barely communicate as he battled raging fever and sepsis that poisoned his blood. Abeje and I were at his bedside continuously, anointing Dad, providing morphine and other care.

This Titanic strong man, this New Jersey and Pennsylvania track star, rose to his final hurdle. I held and kissed him, calling my, Kathy's, and all our love into his ear, as he fought with every last fiber the air hunger that in the end took him from us and upward to heaven. I kissed and spoke to George as his breathing ceased, and caressed his wrist and neck until his pulse was no more.

George was an immensely strong man. His strength is not lost. You see it in his family. Kathy who works a farm, teaches school, and raises a beautiful daughter with Jason. Jim, me, who lived when very few expected him to survive, and fought mightily to gain successful footing in academics, at work, and family. Nathan, his grandchild, who survived a horrific accident when a truck hit him while riding in Tucson; he went on to win and place high in major bike races in the US and abroad.

The Wilson family is a strong family, not just raw physicality, but a family of deep love and courage.

My father gives us all a lesson, an example of a life lived quite well, and the strength to be kind. Let us carry this forward. Thank you.

Saturday, March 12, 2011

Dreams


I've written about challenges and pain. My son's recent injury. Those dying in Africa I've cared for, lives I helped save. My father wrote about my getting hit and paralyzed by a drunk driver when I was 17. I've since lived in pain, with deficits. I continue to improve.

Others have fared worse. My grandfather used to say if you all sat around a table (at a bar, I guess, he was an alcoholic) and put your problems on the table, you'd be embarrassed and pull yours back ... others are worse off. Singer Bono said something like that when he compared our world to the third world: "[I]n the Third World, the gap between an ordinary life there and a life in the West is enormous, almost unimaginable. But the gap between where you are and where I am is microscopic. It's just degrees of luxury."

On balance, I believe, pain or no, poverty or not, we live for dreams. Maslow wrote, we live for ourselves but, once we meet basic needs, we can turn to help others, our community, our children, make the world a better place, attain a sense of love and belonging, the substance of dreams.

Jack Wheatcroft, Bucknell poet and professor emeritus (and one of my academic advisors), taught that we are myth-makers, we create stories to explain the world. I suggest our myths need to reconcile with facts and adapt, or we become stupid, irrelevant. We've seen the crude myths of gods and thunders evolve over the millennia, to science and precision, at various levels. My wife, a molecular biologist, is squarely in the precise paradigm, where I am more coarse, prone to creative conjecture, fresh product designs that decompose to software bits.

I also have high dreams that are more often whispered. The future of the Africa clinic model, certain cyclists, a software product line, heat in the Nubian desert, my left leg. Dreams are larger than the big hairy audacious goals I described last week. They're the entire ether. Much stuff fitting together, elaborate and delicate, assiduously tuned, revised -- abandoned when necessary. Some dreams make it into pictures.





Other dreams are accomplished. (Venga!) On we go.

Sunday, February 20, 2011

Tour d'Afrique 2012

In Built to Last: Successful Habits of Visionary Companies, Collins and Porras write that Big, Hairy Audacious Goals (BHAGs) can be key to greatness -- and sometimes failure. A favorite icon, Steve Jobs, worked to make Apple Computer "insanely great." He set audacious goals -- "the computer for the rest of us" -- and tightly controlled product architectures. Apple is now the planet's most valuable tech company.

In December, my bicycle-racer son, body wracked by an errant truck driver, plotted from his hospital bed to ride and race again in Europe. This March, he's off to Belgium (France, Italy ...) to ride with Team USA. My father, at age 70+, embedded in the Marines in the drive to Baghdad. (A no-fear war correspondent, George initially asked to embed with the Iraqi army.) My namesake, photojournalist James Ricalton, walked across Africa three times, 1895-1908, across Russia and more. When I was struck by a drunk driver, comatose, paralyzed, folks counseled that I'd probably be institutionalized, never walk again. Five years later, I'd graduated from Bucknell and was skiing with the governor of Virginia, helping write and enact drunk driving legislation. I founded and sold a tech company, did some interesting work, wrote a book, and blew-up on the back side of the dot-com bubble. I co-founded a maternal and child health clinic in Ethiopia that has treated 3,000+ indigent patients since inception in December 2009.

Difficult goals and steadfast pursuit. Sometimes messy.

I suffer from central pain syndrome, have been diagnosed with dysautonomia, slow failure of the autonomic nervous system. I have bad days. I'm risk averse -- I take extra caution not to hurt myself, am somewhat slow and methodical, spend a lot of time anticipating danger. Since 2001, I've been a consultant and, now, director in the banking regulatory sector, building software. (My products will help drive the new Consumer Financial Protection Board ... helped make TARP successful.) Steady, conservative gruel.


So what's this Africa business? It's another balancing act, between the imprint of my father's audacious bloodline and my mother's disciplined, engineer-led style. (Pictured above is pole-vaulting George and mom's dad, GM chief engineer H.R. Gibbons.) My BHAG? I'm going to ride a bicycle from Cairo to Capetown. In January 2012, I aim to ride the 2,000 Km first section, Cairo to Khartoum, from the pyramids, across some miserable desert, along the Red Sea, then up the Nile into Sudan. If things work, in 2013 I'll ride the nasty, mountainous Khartoum to Addis leg, perhaps beyond. Camping in tents. 12,000 Km all told. Run by a top notch firm, Tour d'Afrique (TdA).

Why? A lot of reasons. Life is short. I've been repressed by injury. I love Africa. I will live longer if I keep my body in shape. I'm an avid photographer ... there will be good pics. I have obligation space -- the kids are in college or nearly so, our house is in order, my wife is supportive. I'll probably align to help charity. It's less dangerous than Everest. Ricalton was there. My vaccines are up to date. It could be fun ...



To prepare, I'm reading a lot. There are a number of very good blogs by folks currently riding TdA (e.g., 1, 2, and 3). I've bought a suitable bike, a Specialized Evo 1x10 hardtail 29er (above), and I'm riding a lot. Next year's Cairo to Khartoum segment is not too bad, about 15 days riding 80-110 miles per day, flattish, with a day off on the Red Sea and a day in Luxor. The harder thing for me will probably be the heat (up to 120+ degrees F), grime and tiredness. I'll do long base miles on the C&O Canal towpath, with some overnight camping interspersed by off-road agility work to improve balance, some heat work to acclimate to desert, and mountains as my weight drops. Yoga, stretching and core workouts will help with 'pretzel' pain. I'll probably drive my weight down from 195 to 175 pounds (a bit more than what I usually do March-October).

There you have it. A first draft. My next BHAG. It may not work, but I think it will. I look forward to sharing thoughts on TdA and learning from everybody. Want to ride?

Take a look at this compelling video ... more vids here.

Saturday, January 29, 2011

Balancing Act

It is difficult to hold your son’s hand, after receiving a phone call and flying across country overnight, to look at his misshapen and lacerated face, eyes filmy, conversation disoriented, perseverative, a gurgling cannula sucking blood from his mouth, oxygen in his nose, multiple IVs.

On the other hand, it’s not difficult. It is exactly where you want to be, your every fiber seeking to draw out the pain, heal the tissue, do the right thing. Eighteen hours ago, he was laying on a Tucson street, bicycle broken like matchsticks, hypotensive, airway filling with blood, dying; the victim of a negligent driver. Eighteen hours before he was a joyous teenager, a top of-his-game espoir, bound for European races and national team slots, working ardently at winter training. Prompt EMS, suction and IV saved him, opened his airway and restored circulatory volume. Open reduction surgery with internal fixation by titanium plates and screws would rebind his jaw, fractured in a dozen places, eight teeth knocked out across the top of his mouth, right condyle snapped and dislocated, fractured left subcondyle.

This I balance five weeks post trauma. He’s had a remarkable recovery. His legs are strong, as are his lungs. His power is up, exceptional watts per kilogram. Six hours today on the bike, riding out from our house near Washington, DC. "Let him go, be the wind at his back" -- I tell myself. This I will do, but it is hard. When I was about Nathan’s age, a negligent driver ran a red light and hit me. At the time, January 1977, my own father wrote:

As I stood there in the hallway outside the Emergency Room, I saw Jim standing vibrant, healthy and loving in the family room and cursed myself for not putting my arms around him and persuading him to spend New Year’s Eve at home with us. He was close to doing so – if I had only held him at home. If, if – there were so many ifs to ponder as I waited for the double doors of the operating room to open … The doors finally parted ... [Jim's surgeon] talked briefly but directly. Jim was in grave danger. It would be several more hours before we knew whether the brain’s swelling would reach fatal proportions or stop … They wheeled Jim out. His head was a white turban of bandage. Tubes were in his arm and nose. We tried to touch him as the attendants wheeled him past us on the quiet rubber wheels of the stretcher. I probably called out what I had heard and said dozens of times on the battlefield but seldom believed: “Hang in there. You’ll be all right.”

With this, I work to balance the eerie burden of repeated history. I wasn’t as lucky as my son, my injuries deeper and harder to compensate. Where does a parent draw the line? My two boys began bike racing at ages 10 (Avery) and 13 (Nate). For us, it was the next stage beyond youth soccer, basketball, lacrosse and whatnot pediatric sport mayhem. A phase. But cycling became more, a unifying principle around which our family organized our lives, travels and passions. And the boys became good, very good. Racing around the country and internationally. Cycling is the main thing; both boys wish to become professionals, have guided their college selections towards physiology and sports. Who would have thought? This from a family of scientists, software geeks, lawyers, writers and school teachers?

Cycling is the path that is before my sons, their passion and desire. It is a beautiful thing, their choice. Their hard work and success will bring not just individual victories, but will also lift others seeking joyous and healthy lifestyles. While I urge caution, the Tucson experience is a stronger caution than any can imagine.

Will I feel bad at the next accident? Of course. And we will be there, with every fiber and talent we possess, as we care for those we love, gently enabling their passion, the next podium, the beautiful slice through the sun and air.

Nathan and Avery Wilson, Sonoma California, 2008.

Tuesday, December 14, 2010

Christmas Letter 2010

Christmas letter. I'm not religious. I've been disappointed by religion. I have a lot of faith, but those who try to organize faith, too often, mess things up, undermine natural, in-born talents for sensitivity, growth, love, what's right. Ask the mothers of kids who are sent on violent jihad, or the boys servicing a priest ... measure the richly jeweled who cry 'hosanna' ... messy stuff ... keep the faith, but hold your own mind.

Aduare district, Addis Ababa, January 2010.

2010. This was a great year, dramatic. I don't think I've had such a year since 1977, when they opened my skull and cut the dura, saving my life, throwing me down a deep crevasse. This year, with partners, but principally my design, I launched and structured a health care program in Addis Ababa. We treat 200-300 indigent women and children each month, folks who subsist on $100 US per year or less. I worked there in January, and bonded. The program in Addis is excellent. Painfully, I found the collateral effort in DC misshapen, and stepped away.

HPC, Hefler Performance Coaching, initial center, Herndon, Virginia.

A friend said I'm an enabler. But not like a supporter of negative addiction. I take pride in enabling folks to hit their goals. My friend opened a shop to support a healthy lifestyle, kids and adults bicycling. It's going great. In turn, she, Sue Hefler, helped my boys hit high marks, we established the dominant junior bike team in the mid-Atlantic ... my old boy (19!) Nate rode for Kelly elite amateur and Team USA ... did Vuelta a Guatemala in October, will tour Europe with Team USA this spring ... 16 year-old Avery raced across the country, from Battenkill, NY, to Bend, OR, to Bunny Hop about DC. Avery's nailing his senior year, diploma in three years, sharp, then he's onto an incredible gap year, Machu Picchu, bike races around the US and maybe across the pond.

Silver medalist, Fitchburg Road Race, and then some ...

Avery on the front.

Avery and Soot.

I had fun biking, started mountain biking on a single-speed 29er, 'Sparky' (below). Epic rides in the Cascade, Olympic and Appalachian mountains, the C&O Canal, full length, up and back ... I find the mix of biking in wilderness and photography relaxing and energizing.

Jim's bike on Olympic Peninsula, near Sequim.

View from Jim's new office.

At year-end, work is interesting. I'm helping with the merger of two agencies, reshaped by Dodd-Frank. Good work, smart people, building something new -- systems integration, data, large complex stuff. First time in years I've slept well.

My incredible wife, Carolyn. September 2010, 25 years ere we wed. Wonderful! She's achieved much, professionally and personally, and been my lift, a rope out of the crevasse. Beyond top scientist, Care is a great fitness acolyte, stronger now than any other time ... dropping me on the climb up Mount Bachelor.

A new, wonderful dog, Soot, completes our team ... so many good things ... On we go.

Avery's boxer, Soot (Minstrel Coal Dust).

Neighbor, friend, beloved. It's been a wonderful year. You've been a part. Thank you. Now we look to 2011. 2011 is a prime number. Let's work to make it great, a prime year, marking what we do, making the world a better place.

Much love -- Jim and family

Tuesday, September 8, 2009

Fitness

I've shifted gears on the fitness front. Usually, this time of year, I've dropped about 15 pounds, the result of riding over spring and summer. No such luck this year, though I've ridden hard. What happened? In March I started Lyrica (pregabalin), a seizure med that is experimentally used to treat central pain syndrome -- from which I increasingly suffer, due to adolescent traumatic brain injury and aging. Lyrica has helped with pain and improved my sleep architecture, but it added pounds and blurred my vision. So I'm weaning myself from the drug and increasing my fitness regimen. I've hired a personal trainer and nutritional consult; bought a high-end Retul bike fit; cleaned-up our home workout room; and am riding as intensely as ever.

Results so far are promising. I do weight training twice a week, ride 100-200 miles/week, and have trimmed my diet. My weight is down a few ticks, and should drop more quickly as my muscle build/burn rate amps. With the weaning, my pain (mostly left peripheral with some spasticity) is increased but tolerable for now. In a couple weeks, I meet with the folks at Georgetown to discuss an intrathecal baclofen pump -- an implanted device to push a low-dose into my spine. Given my current tolerance, I think this may not yet be appropriate, but it's good to understand the option.

Life is good. I feel bad that this pain stuff has taken some engagement off the table -- fewer good days to enjoy with Care and the boys, lost athleticism. The human condition.

Thursday, June 25, 2009

Risk taking


Someone beloved to me said: "Dad, you're too close. You could get hurt." (Don't do that.) I've had crashes almost land on top of me. I'm careful to stay out of the way, to not contribute to crashes. Being close, though, helps grab the decisive moment. I'm not too much for complicated photographic technique, a bunch of flashes and $20K of gear (though my stuff isn't cheap). I think -- my photographic style is -- that the real value, the art, is catching the scene and the context. Recording something very human, pathos. Whether it's slum kids in Cairo, a dying man, or a cyclist on the edge.

Yep. I could get hurt. Here, I'm ambivalent. Because I was gravely injured by a drunk driver when I was 17, I have not had a pain free day in 32 years (excluding occasional, prescribed narcotic drop-offs). My father was a famous war correspondent (and occasional photographer), all the big ones from Vietnam forward. (Age 75, he was embedded with 1st Marines in Iraq,
Kuwait to Baghdad.) My great grandfather and namesake walked from Capetown to Cairo, taking pictures. Two or three times. He walked across Russia with a pushcart. India, Japan, more. I've marched with protestors in Mexico shooting film, and left my girlfriend (now wife) crying on the street while the brown-shirts arrested me photographing Basque rebels in Spain. (Both times my camera and pictures were confiscated or stolen.)

Alas, getting close, it's a bit risky. But -- for a mild-mannered computer nerd embedded in government -- it is vivifying. When I'm done, kaput, I hope it will be a good picture.

Friday, June 12, 2009

EMT Training


This was my second rotation at the Inova Fairfax Emergency Department. My prior study at Inova consisted of about 12 case observations, ranging from care for patients with significant hypertension, respiratory difficulty, wound care, substance abuse, cancer-related medical disability, syncope, and psychogenic issues; as well as procedures such as male patient personal care, cleaning medical equipment, electrocardiograms, ultrasound, and computerized axial tomography (CAT). My preceptor gave me high marks, but apologized that the round was “not very exciting.”

For my second study, I arrived at 6:40 AM, and was assigned to ER triage. The initial observed cases included leg joint swelling, abdominal pain (suspected early pregnancy), severed finger (construction accident), severe hypertension (BP 294/179) with acute abdomen, and a cancer patient with tachycardia (P 200). At about 9:00, we were notified of incoming code yellow and code blue vehicular trauma patients, transported by ambulance and air, respectively.

My preceptor assigned me to stand in a doorway between the two large ER patient care bays. Patient 1, the code yellow, arrived first, and was transferred to an ER bed in bay 1. S/he was alert, responsive and in severe pain. ER staff performed a rapid trauma assessment and identified probable pelvic fractures and lower abdominal injuries. The patient received x-rays in the bay, and was to advance to CAT scan. Cervical spine immobilization and backboard techniques were used throughout patient care.

Patient 2, code blue, arrived and was transferred to a ER bed in bay 2. Patient 2 received a Glasgow Coma Scale rating of 4 at the accident scene and 3 in the ER. (GCS scores range from 3 to 15, with 3 being most severe.) Prior to arrival, the patient was intubated by EMT personnel. The unresponsive patient was catheterized, given intravenous fluids and medications. Rapid trauma assessment indicated no obvious trauma beyond ecchymosis (bruising) and swelling about the left eye, and slowly reactive pupils. I helped transport the patient to CAT scan. I considerately asked a few questions. A medical resident, previously an EMT-paramedic, instructed me to ‘follow [and observe] this patient all day.’ Imaging showed approximately 2 cm midline deviation of the cerebrum. This indicated cerebral hemorrhaging and swelling. The patient and trauma team returned to the ER bay and further medications were administered. The patient received various assessments, including deep foot stimulation, for which s/he was unresponsive. The patient showed seizure activity in the arms. Subsequently, we took the patient to the Trauma Intensive Care Unit (TICU). The patient was evaluated by a neurosurgeon. An intracranial pressure (ICP) monitor was inserted by drilling a hole in the patient’s skull above the right ventricle and inserting a fiber optic measurement device. Patient position was managed, from Trendellenberg (feet elevated) to reverse Trendellenberg to observe ICP. ICP ranged as high as 85; normal is less than 15 mm Hg. Medications, including mannitol (an osmotic diuretic to reduce intraocular and intracranial pressures), were administered. The patient appeared to be roused, moving all four limbs, and a doctor worked to evoke a patient response by loudly calling the patient’s name, asking the patient to show two fingers, slapping the patient’s chest and squeezing the patient’s hand and arm. The patient did not respond to the stimulation.

ICP remained high. Medical staff inserted main line IV routes for high-volume administration of medications in the patient’s chest and arm(s). I maintained traction on the patient's right arm, to help manage swelling caused by the new line. Doctors indicated that surgery was required. We took the patient for a further CAT scan in order to image the current positioning of the brain. The patient was taken to an operating room (OR). Because I was not wearing surgical garb, I remained in an outer hallway. The patient was prepped for surgery, head shaved and orientation lines marked on the patient’s head (with lines indicating a left-superior cranial incision arc, from the top of the head to above the left ear). My preceptor returned from the OR and saw that I was outfitted in surgical garb — hat, mask, shirt, pants and booties. I put on gloves in the OR. There were approximately 12 medical personal in the OR, including the neurosurgeon and resident. I stood out of the way, about six to twelve feet from the patient, observing medical procedure and asking infrequent questions. The surgeon cut a rounded triangular skin and tissue flap (approx. 10x15 cm.) from the patient’s left superior cranium, and lifted this flap back to expose the skull (cauterizing vessels/tissues in the process). The surgeon drilled approximately six burr holes on the perimeter of the exposed skull area. (This procedure is termed craniotomy.) When the surgeon(s) subsequently pierced the dura mater beneath the skull, cerebrospinal fluid and blood gushed from the opening(s). The burr holes were connected by the surgical drilling/cutting instrument and the patient’s skull segment removed. (This procedure is termed craniectomy.) Incisions were made into the dura mater. Upon broad opening of the dura mater, the brain herniated about 2-3 centimeters from the plane of the skull. This was dramatic. It looked like patient’s brain leapt from its container. Several medical staff commented: “Did you see that? ... That’s not good.”

Surgeons reattached the patient’s skin and tissue flap and conducted various closing and wound care activities. I accompanied the patient back to TICU. The patient’s ICP was reduced, but s/he remained in critical condition. At 3:30 pm, I excused myself, returned my surgical garb, met with my initial preceptor (in ER triage), obtained signoff, and returned home.

[material redacted]

Friday, January 13, 2006

Eulogy for Joan

Jim Wilson, January 13, 2006 – Western Presbyterian Church

Thank you, John, Bill, Carol and Dee. Thank all of you for coming to honor and remember the life and spirit of my mother, Joan Wilson.

Joan’s afflictions
Spinal stenosis w/diffuse arthritis, senile dementia and, in the end, amyotrophic lateral sclerosis – Lou Gehrig’s disease.
George’s valiant and loving partnership.
Searched the world for best doctors – from Johns Hopkins and NIH to Mayo Clinic …
Five days and nights – mostly without sleep – by Mom’s side at the Hospice – a true and wonderful example of love and devotion, “until death do us part.”
We are here, however, not to dwell on this sad end but to celebrate the extraordinary wonder of Joan Wilson’s life and to carry forward her spirit as we measure and make our own lives.
I am going to talk a little about where Joan came from, where she went, Joan as a mother and friend. Joan was born and raised in Chatham, New Jersey.

Father -- Harold Ralston Gibbons – Ral
Ral came from a modest background; his father Samuel was a roofer.
With his parent’s urgings, Ral worked hard, graduated from Stevens Institute of Technology in 1913. From there, he followed in Alfred Sloan’s footsteps to become Chief Engineer of General Motor’s Hyatt Roller Bearing.
Ral was Chatham’s School Board President, staunch conservative, strong work ethic; demanding of his daughters, Lois and Joan. You must always serve, Ral frequently intoned to my mother.

Mother – Dorothy Binns -- Dot
Descendent of poor French and Irish Canadians.
Dot’s grandfather, Malcolm McEachern, was a war hero, who died the Battle of Ridgeway, 1866. Mom often told me about Malcom’s statue in Toronto and shared his war medal with me.
Dot was a World War I nurse, serving at Camp Coetquidan in Brittany, France. She cared for numerous soldiers and prisoners of war. After the war, Dot married Ral, his second wife, and cared for Ral’s grievously ill son, Junior, who soon passed away.
Mom often told me how compassionate Dot was, providing food to families at her back door during the Great Depression.
Together, the Gibbons summered at their house on Barnegat Bay, where Joan became a great sailor and developed a deep love of the outdoors and the water.
Wonder of Life

Home in Chatham
Joan was always very proud of her parents and her family; their solid nature and immense and dutiful charity. Almost every time I saw Mom in her last months, hobbled by ALS, with great loss of dignity, Mom would look up from her sad fog, and tell me to remember that she came from a good family; that despite appearances, she was a good person, her roots were sound.
Joan was an excellent student and a gifted musician – playing saxophone, piano and clarinet.
Field Hockey and sports star.
Most popular Senior in her high school class.
At Bucknell she was an honor student, a Phi Mu enriched by many friends.

George and Joan
From her staid, perhaps confining, upbringing Joan found something refreshing, something entirely different – SAE fraternity President, WWII Navy fly-boy, and aspiring boy reporter George Wilson.
A guy who had a passion for art and adventure and for changing the world, making it a better place, righting what is wrong … A guy whose family was, to be frank, nonlinear. George’s maternal grandfather, for example, crossed the ocean 39 times, walked from Capetown to Cairo, walked across Russia, and stepped into the jaws of many adventures. On his father’s side, Dads was descendent from a gallivanting Senator and Supreme Court Justice, Founding Father James Wilson, who fled Pennsylvania to avoid being thrown into debtors’ prison.
Joan loved George and was a great admirer of his work and passions, his many excitements; but this new life she chose also proved to be a painful stress that Mom conscientiously and very privately worked to balance with her innate sense of the world.
Mom deepest and greatest passions were her children, my sister Kathy and I. We were Mom’s anchors.
Mom did so much. I am going to offer a few snapshots.
Den Leader. Baseball partner for Jimmy. Guiding my sister and I through hours of homework, especially science and mathematics. Helping us to have fun – and lots of it … skiing at Sugarbush and Sugarloaf, taking Kathy to horse shows, cheering us on at swim meets, backpacking at Rocky Run and in Yellowstone, tobogganing on Washington’s Big Hill, swimming in the streams of Great Falls Park, catching an enormous – 42-pound – striped bass in the surf at Block Island, sailing with me across the Severn River, fishing with Walter Reed and the boys in Chincoteague...
Partnered to run the Lafayette Elementary School fair. I remember catching tens of frogs, snakes and critters to stock the school’s Pet Booth. It was chaotic but it was real. This woman was vivid, fully and richly engaged in life, in her kids and what was going on in her community. She put her arms around an immense chunk of humanity.

Amidst all this action, Mom was always there, sympathetic – sharing and helping child or adolescent negotiate numerous uncertainties of growing-up and encountering the world. She was always non-judgmental and unconditional in her love.
She was also very courageous. It wasn’t easy being George’s wife; he would often go off to the wars and conflicts of our time – once he left on an aircraft carrier for seven months, having just bought a new house that Joan never saw. Mom dutifully packed and moved across the river.
I remember in 1968, George was in Vietnam, the Tet Offensive came, The Viet Cong infiltrated Saigon. Dad was often at the front lines. Joan lost 20 ponds from her already slim frame. It was a scary time. She wanted to make sure Kathy and I had good experience when Dad was away. I can remember her crying as she worked to light the hibachi by herself at the Memorial Day cookout at our summer place in Sherwood Forest. Some guy made fun of her, with her two little kids; but Joan bit her lip and soldiered on.

Mom was an inspiration when I was recovering from near fatal car accident, brain surgery and paralysis; again, the compassionate partner and confidant in a near impossible mission. Not just in the ICU, but the many months – if not years – of delicate, stressful and compassionate care for a grievously injured child, a young man of 17 who had to re-build his world cognitively and physically, from the wheelchair on out. Joan would patiently hold my belt loop as I struggled to walk, and she endured my black depression and tantrums.

She was an extraordinary mother.

Mom was always there for us. With her, I knew I would never walk alone. And it was not just me. It was all of us for whom Mom lived, her friends, her family, her many thousand school students. She made this a better world.

I thank you and urge you to carry on Joan Wilson’s wonderful spirit and to know that, in a way, she is with you.

God Bless.

Saturday, January 1, 1977

Backstory -- 1/1/1977

This is a piece my father wrote about 1/1/1977. Published here as backstory for another note titled "Dreams" ... I've written chapters past this, an undergraduate play, painted, other products of traumatic inculcation -- but they remain mostly in a box.



© George C. Wilson, 1977 (as edited, James R. Wilson)

The telephone call every parent dreads, and thousands get – especially on New Year’s Eve – came to our house at 2 a.m. on January 1, 1977.

“Mr. Wilson,” said the woman at the other end. “This is Fairfax Hospital. Your son has been in an auto accident. He is severely injured. We need your permission to operate. There isn’t much time.”

Questions flooded my brain. How did it happen? Where is he hurt? Who is the doctor? What does he want to do?

She could answer some of them. But she needed a decision from my wife Joan and me. Immediately. She repeated that there wasn’t much time. She told me that the surgeon poised over my 17 year old son, Jimmy, was Dr. Ezel Dogan. He was the surgeon on duty at Fairfax, Virginia, Hospital this New Year’s Eve.

Ezel Dogan. Who was he? I had never heard of him. I thought the worst: An ill-trained foreign doctor whom the regulars had stuck with the New Year’s Eve duty. How could I entrust my son’s life to him over the phone?

The Fairfax Hospital caller also told me roughly what Dr. Dogan wanted to do: drill several holes through the top of Jimmy’s head to determine how seriously the brain was injured from the severe blow Jim had received on the left side of his head in the auto crash. The holes would also absorb some of the brain’s swelling if it pushed against the top of the inner skull. The immediate worry was that the brain would swell so much that it would crush itself against the internal skull, snuffing out our boy’s young life.

Couldn’t I first call another doctor – one I know? No, the caller explained, there was not enough time for this. Jimmy was hurt too seriously to move. Dr. Dogan must start drilling within the next few minutes to help save Jim’s life.

Joan and I saw no alternative to giving our consent to letting this unknown doctor drill into the golden head of our boy. We gave it: then made a dash for the hospital over the same roads that had almost claimed Jimmy.

We spoke few words on the way. Neither of us cried. Each sensed that one must reinforce the other for making the other hard decisions ahead of us in the night. Joan is a math teacher; I’m a journalist. She tends to put her faith in people, especially professionals like doctors. I tend to question everybody and everything and ponder the dark side of issues at hand. I feared the worse. Gruesome pictures from auto accidents I had covered as a young reporter and from wounds I had seen as a combat reporter in Vietnam galloped through my mind.

I swung our car to the entrance of the sparsely lit Fairfax Hospital and dropped off Joan. I parked, then sprinted to catch up to her. We went to the Emergency Room. Jim wasn’t there. He was already on the operating table. All we could do was to wait outside the operating room in hopes of seeing Dr. Dogan and Jimmy. We stood against the green wall, shoulders touching; seldom speaking. I thought how close we had came to avoiding this tragic morning.

Jim had been invited to a neighborhood New Year’s Eve party but was not sure he wanted to go. He enjoyed the warmth of his home and the love of his parents. Yet going out New Year’s Eve was the thing to do. His sister, Kathy, was out. Several of his teammates from the Langley High School rugby team would be at the party. Maybe he should go, too. He got dressed up but lingered with us in the family room as we watched a New Year’s Eve program on television while the fire crackled. He asked to use my 1971 Mercury Cougar rather than the more sedate 1975 Chevrolet Malibu which Joan drove. I consented, after delivering the usual cautions about not drinking and watching out for drunk drivers whom imperiled everybody on New Year’s Eve. He promised to be careful, reminding us that the party was only a few miles away. Still he hesitated, standing uncertainly for a while at the edge of the family room before departing.

As I stood there in the hallway outside the Emergency Room, I saw him standing vibrant, healthy and loving in the family room and cursed myself for not putting my arms around him and persuading him to spend New Year’s Eve at home with us. He was close to doing so – if I had only held him at home. If, if – there were so many ifs to ponder as I waited for the double doors of the operating room to open.

The doors finally parted and out came a fulsome, slightly stooped man with dark hair and solemn brown eyes in the surgeon’s garb of green gown and hat. He was Dr. Ezel Dogan. He talked briefly but directly. Jim was in grave danger. It would be several more hours before we knew whether the brain’s swelling would reach fatal proportions or stop. He could tell from peeping through the freshly drilled holes in Jim’s skull that there was still some room for the brain to swell before hitting the wall of the inner skull. Youth was on Jim’s side. A man only twice Jim’s age would not have survived this long, Dr. Dogan told us. The head injury was that bad. Dr. Dogan advised us to go somewhere and await developments. Jim would be under intense observation in the recovery room.

The double doors of the Operating Room opened again. They wheeled Jim out. His head was a white turban of bandage. Tubes were in his arm and nose. We tried to touch him as the attendants wheeled him past us on the quiet rubber wheels of the stretcher. I probably called out what I had heard and said dozens of times on the battlefield but seldom believed: “Hang in there. You’ll be all right.”

Dr. Dogan started walking away from us to tend to Jim. I caught up to him and asked him out of Joan’s hearing what were Jim’s chances. He leveled with me. The odds chilled me. Jim was in an uphill fight for survival. And I was to learn in the next few moments that there was no good reason for him being near death. A man previously had been had been convicted of drunken driving had rammed into the side of the Cougar at an intersection, throwing Jim – who was riding in the front passenger seat against the door framing on the driver’s side. The impact had inflicted a frightful blow to the left side of his head.

Joan and I got these sketchy details of the accident right after leaving the hallway outside the Operating Room and entering the hospital lobby. There a group of teen-agers who had happened upon the accident scene minutes after the collision were sitting in the near dark, sweating out Jim’s struggle for survival. One of the girls was the sister of the teen-ager who had been driving my car, Robert Morley. Jim, figuring he had drunk too much champagne, had handed the car keys to Robert as they left the party. They drove along Churchill Road in McLean, Virginia, slowed down while approaching the red light at the Dolley Madison Boulevard intersection and then, by Robert’s sworn testimony, started across the boulevard when the light turned green. A van driven by George F. Burton, 35, came barreling out of the night, and, again according to sworn testimony, went through the red light and slammed into the Cougar Jim was riding in. He had not fastened his seatbelt and shoulder belts. He was knocked unconscious in the collision. Robert suffered a comparatively minor knee injury. Burton escaped with minor cuts and bruises. The Fairfax County policeman who responded to the accident and was interviewing the teen-agers in the lobby when Joan and I arrived there told me that Burton apparently went through the red light at the intersection. He said Burton was not subjected to a drunk driving test because he had received some medication at the hospital, which, a lawyer could argue later, could skew the sobriety test. I was furious Burton had not been tested.

Joan and I left the lobby for the Emergency Room. I got my first look at Burton there. A smallish, brown-haired man, he was sitting in a wheel chair with splotches of Mercurochrome over his face cuts. I glowered at him. He said something about being sorry. I wanted to kill him right then and there. I could have strangled him in his wheel chair without a twinge of conscience. I still don’t know what held me back. Maybe convention. Maybe Joan. She said nothing at all to him. I growled at him with a furious, “You know you may have killed our son.”

We learned from the hospital people that Dr. Dogan wanted to do some more surgery on Jim this long New Year’s day to assess the brain damage. The idea was to insert a small tube in an artery leading to the base of Jim’s brain; slide the tube up near the brain and then shoot colored dye through the tube and into the blood vessels running through Jim’s head. The dye would be photographed as it made its way through the brain, revealing such damage as blocked passages and clots. The procedure is called an angiogram. Dr. Dogan warned us with great solemnity that the test was risky. The tube might go off course or trigger some other adverse reaction as it was inserted in Jim’s arteries. But it was important to make a further damage assessment to help determine what to do next. Fairfax Hospital had just ordered a machine that would do all this examining entirely through rapid-fire x ray pictures, eliminating the need to poke tubes into the arteries. But Fairfax Hospital’s CAT (for Computerized Axial Tomography) Scan was not yet ready for use. Jim was too sick to move. He was in a Coma. Paralyzed. Would we give the go ahead for the angiogram later on this darkest of all days for us? Since we had several hours, rather than seconds as before, to make the decision, I said we would call the hospital with our answer later in the morning.

We could not visit Jim hanging onto the edge of the cliff separating life from death in his first hours in the Intensive Care Unit where he was placed after undergoing the operation. We understood. We did not want to cause any kind of vibration at this crucial moment that might start him sliding over the edge of the cliff. We returned home to Great Falls to ponder the go or no go decision on the angiogram. I had never spent a single night in hospital myself – knew little about such surgical procedures. I wanted to talk to someone expert in the field – someone who knew about the forbidding world of head trauma. I could think of only one person that early Saturday morning, Dr. Alfred Luessenhop of Georgetown University. His son was in Jim’s high school class at Langley. It was only 7 a.m. But I was desperate for expert guidance. I dialed Luessonhop’s home number, and he answered. This eminent brain surgeon could not have been nicer or more helpful to this caller from out of the blue.

“How old is he,” Dr. Luessenhop asked of Jim when I explained my dilemma. When I answered 17, he replied: “The risk is minimal for someone his age.” He asked a few more questions and then gave explanations that added up to a compelling case for going ahead with the angiogram. He signed off with the reassurance sounded on a hundred battlefields: “He’ll be all right.”

We consented to the angiogram. Jim got through it without suffering any further slips. But there was no sign that he was recovering from his deep coma. We were granted permission to visit him for 10 minutes, five times a day: at 1, 3, 5, 7 and 9 p.m. Our first visit was searing for me. There was my brilliant, well muscled, vibrant and compassionate son of 24 hours ago lying helpless on his back in a room full of other people fighting for their lives. We had been more than just father and son in the conventional way. We were best friends, all the way through. We had played almost every kind of sport together; built models together; camped together; canoed down rapids together; hiked through Glacier National Park together; wrestled on the living room rug until he became too big and strong for his old man to handle. And today this same, wonderful son of my mine was that lifeless lump under the sheet because some drunk had gone through a red light. The nurses had had to tie his hands and feet to the bed so the body could not have its way and assume the fetal position it often took just before death.

Jim emitted no sound, moved no muscle, as we looked down on him. He was just a helpless boy with tubes running into his nose and arm to keep him linked to the living whether his body wanted to live or not. The nurses in the Intensive Care Unit urged us to say familiar things to Jim in hopes of breaking through his coma and arousing him to consciousness. Joan and I and Kathy, his 18-year-old sister, said everything we could think of to break Jim out of his deep and sapping coma. But there was no response, not even an eyelash flutter, in the 10-minute visits of that first day. We sat in the hospital hour after hour, day after day, praying the next 10-minute visit would be the one in which Jim showed signs of life. His high school friends, teachers, our friends – they all came into the lobby to encourage us. One neighbor, Fran Luke, had her church collectively offer a prayer for Jim. Other Catholics lit candles. Joan’s associates at Cooper Intermediate School and mine at the Washington Post visited, sent meals, prayed. Jim had everybody pulling for him. But head injuries are little understood. There is not much doctors can do to repair them. The brain is a wonderful but immensely complicated organ which science is just beginning to understand.

We did learn the fundamentals of Jim’s problem from Dr. Dogan and others. When someone suffers a severe blow on the left side of the head, the brain suspended in its protective helmet of skull is knocked against the right side of the inner skull. This bruising collision, called a concussion, can damage the right side of the brain which controls the left side of the body. A boxer is only knocked out if his brain is jarred against the inner skull from a punch. But he can be killed instantly if the blow is so powerful that the brain is smashed against the inner skull. The harder the brain is hit, the deeper the unconsciousness. Deep unconsciousness is a coma. People can remain in comas for days, weeks, months – even years – before dying. The longer one stays in a coma, the less chance there is for a full recovery if the victim does regain consciousness. Deterioration of the muscles and hundreds of other parts of the body and mind marches in mercilessly. This much we knew as we tried five times a day to wake up our boy.

Saturday, Day One of our trauma and the New Year, nothing came from Jim. Sunday nothing. Monday nothing. We kept hoping the next day would bring some sound, some movement from our paralyzed Jimbo as we returned to our dark home each of those winter nights. We never gave up hope, but were emotionally and physically exhausted after just these first three days in the special hell that is reserved for loved ones of head trauma victims. Some people are doomed to this hell for years, struggling day after day to break the death grip of a coma. No one could predict how long Jim’s coma would last or what shape he would be in mentally and physically if he broke out of it. We could only keep on fighting with everything we had – which was little more than love and determination.

On Tuesday, Day Four, Joan, Kathy, and I crowded around Jim’s bed in the Intensive Care Unit once again to try to provoke an association, which would restart and reconnect his brain circuits. Kathy, a sister whom Jim deeply loves, said: “Jim, you know you have a dog. She’s a Springer Spaniel. What’s her name?”

Movement suddenly came from under the sheet. Then Jim’s mouth opened and he issued a ragged answer that sent our spirits soaring for the first time since that awful New Year’s Eve phone call: “Win-nn-eee!” He had made an association with his dog, Winnie, and spoken her name. Kathy had broken through. Jim’s wonderful mind was working again.

Joan asked: “Jim, do you know where you are?” He replied: “In the hospital.” Our black despair lightened. God was being kind. But we all still had a long way to go to reach the daylight of full recovery.