I found myself walking through the front door of my house at 5:30pm yesterday, not remembering where I'd been. In actuality, I'd just walked two blocks from the new circuit-training fitness center when I had done a trial workout. The thing is, I only remembered the first two-thirds of the circuit. I didn't remember walking home and a lot of other recent details were pretty fuzzy. A trip to the ER was clearly in order and my wife drove while I slowly downed a couple of liters of electrolyte. I felt light-headed and dopey, but slowly began to feel better.
I felt well enough to be dropped off at the entrance, to walk through the security screening by myself, and to tell the triage nurse my complaint: There were 15 minutes of the last hour of which I had no recollection. Even as the words were coming out of my mouth I couldn't believe I was saying them.
No offense to anyone out there who works in the health care profession, but I hate hospitals. I've watched my mom and two sisters slowly waste away in hospitals while the world shimmered just outside the window. Just being in a hospital gives me the creeps. Nevertheless, the ER staff was friendly, courteous, and on top of their game.
Within minutes I was hooked up to an EKG, breathing oxygen, and unsure what was going to happen next. A CT scan of my brain, a chest x-ray, an EKG, and preliminary blood tests revealed ... nothing. And I was feeling better and better as my sensorium became clearer. Within an hour, I felt like my old self, with one, new, sinking realization: The FAA medical certificate in my wallet was toast. It was like a switch had been thrown and I was no longer fit to be pilot-in-command. And it was clear that the ramifications of this event were lost on the doctor and staff.
After three hours, all subsequent tests had come back as "normal" and I went home with a diagnosis that really didn't seem like a diagnosis: Transient Global Amnesia. A rare syndrome that usually occurs in adults over age 56, TGA is idiopathic - the underlying cause is not known. The vast majority of people who experience a TGA episode have no recurrence in their lifetime. There are no long-term adverse effects, no course of treatment, no medications, nothing to do, no action to take. Understandably, the FAA doesn't like events for which there is no clear cause and getting a new medical certificate will require up to 2 years.
Yet for being so benign, experiencing a TGA is decidedly unsettling. It's odd to not remember part of your day and it's oh so easy to imagine that you must have some sort of serious disease - a brain tumor, vascular problem, the nightmare list goes on and on. You just have to trust that the EKG, CT scan, xray, blood tests all attest to your health. Of course, there are more tests.
Today I visit the neurologist after the appointment desk calls me at 8am, an amazingly prompt response since I was just in the ER last night. My wife drives me to the doctor's office, I register at the desk and have my blood pressure taken. The doctor arrives and she's friendly, but no-nonsense. She asks me, among other things, to repeat three words - newspaper, telephone, flower. She has me repeat them three times and says she'll ask me to repeat them again in a few minutes.
I count backward from 100 by 7. I spell "world" backwards and duplicate her drawing of two simple hexagons. I draw the face of a clock, including all the numbers and draw the hands showing 10 minutes to 8. I tell her where I am, the name of the building, the city, county, state and country. I tell her the date and day of the week, who's president and the past presidents going back three-plus decades, carefully distinguishing between George W. Bush and George H. W. Bush.
I touch my right thumb to my left ear. I follow her moving finger with my eyes. I stand with my eyes closed and my feet close together. I walk heel-to-toe. With my eyes closed, she draws the outline of numbers on my upturned palms and I tell her what the numbers are. She examines my retinae, tests my pupillary response to light, tests the strength of my muscles and all of my reflexes. I say "ahh," then squint, then smile on command. I'm anxious, but after several minutes, I still remember "newspaper, telephone, flower."
A few more tests need to be done, but two things are clear: I'm apparently healthy and my day-to-day life has dramatically changed. How will I earn a living? With whom will my students train now that they can't train with me? Three days ago I demonstrated flying an ILS approach down to minima to ATP standards in turbulence and 25 knot, gusting winds. Today, and for the immediate future, I'm grounded with many questions left unanswered.
Once again, the shimmering, fleeting quality of life comes clearly into focus.
Tuesday, October 14, 2008
