The Psychology Test

I can’t say enough good things about the Rusk Institute of Rehabilitation Medicine…. subject to one caveat.  Setting up, or checking in for, an appointment is an exercise in occupational therapy in itself.  After getting through the process, one is disorientated, anxious, and, generally, functionally impaired. For example, the day before my initial neuro-psych rehab appointment, I got a call indicating that I should report on hour early for intake.  Given that I’d gone through an extensive intake and check-in procedure at the same location for my first out-patient physical therapy appointment a week or so earlier, and even registered for the fancy palm-scan check-in, I wasn’t sure if this would be necessary.  After calling every number associated with the psychology department that I could muster, I was none the wiser, since nobody picked up at any of the numbers.  I left a message on the morning of my 2pm appointment, but nobody called back.  I checked into the psychology department, and did my fancy palm-scan check-in, but nobody made any inquiry about intake documents.  In fact, it didn’t come up until, just as I was comfortable that there were no problems, my doctor came to collect me for my appointment and asked the receptionist for my non-existent documentation.

So, the receptionist and I went back down to the ground floor and picked up the requisite papers and questionnaires, and I sat in the waiting area filling them in with a whole bunch of the same answers that I’d previously filled in for the physical therapy intake, together with some additional information with a more neuro-psych slant.  The information required was very detailed and, to a large extent, related to the facts surrounding my stroke, and the ensuing hospital stays.  Fortunately, nothing had happened to screw with my short term memory during that period.  (Eh…?  Oh….)  Eventually, the doctor decided that we would have to press on with the examination/interview part of intake, so the balance of the paperwork would have to wait….

The examination parts of the session went OK, I think.  Counting down in leaps, identifying words and images, matching images with letters, remembering numbers and reciting them back in a different, requested, order, were all fine.  Well, the last one was a little tricky when enough numbers were loaded on.  I did manage to screw up one of the old Rusk favorites though: I knew who the president was, the year, the month and the date.  But the day?  After spending it up to that point navigating the intake procedures and going though a long, detailed informational interview – and not having a job to go to – I had no idea whatsoever.

Nevertheless, the interview portion of the day was pleasant enough.  My doctor seemed capable, informed and business-like.  And what’s not to like about an extensive psychotherapy-style interview?  It’s the closest I’ve come to being the subject of a feature interview in an early-nineties issue of Select magazine.  And what person who posts a detailed account of his thoughts and actions on a blog twice a week wouldn’t welcome the opportunity to talk interminably about himself?  And, as if I was a British indie star of the late twentieth century, the conversation did turn to the subject of alcohol use.  I can only surmise that my accent was what led to us discussing the associated risks (especially for a stroke patient) at such length that my doctor felt the need to clarify that she wasn’t a teetotaler or temperance advocate.  Yet, not only had I not said anything to indicate a craving for beautiful, tasty booze, I don’t even drink much in the wake of my stroke.

The drink’s a terrible thing…

In any event, it was an educational meeting, and I got some interesting hand-outs regarding brain injuries.  Perhaps most interesting was the piece on right and left brain injuries.  Beth has expressed the opinion that a having a right-brain/left side stroke may have been the preferable, er, option for me, since I’m so left-side dominant that I wasn’t likely to succumb to left-side neglect (or, inattention to the left side of the body).  Interestingly (I think), the part of my hand-outs describing the effects of injuries to different sides of the brain (scroll down to “Left or Right Brain”) lists “left neglect” as a deficit resulting from a right-side brain injury.  It doesn’t list “right neglect” as an injury resulting from a left-side brain injury.  I can only guess that this is a result of our society’s bias against the left-handed among us, the southpaws, the sinister (a little illustrative latin for you, classicists).

Pens, pencil sharpeners, scissors, peelers, safety cut-off switches… all designed for right-handed people.  Is it any wonder that lefties die, on average, nine years earlier than the right-handed?  Some people would have you believe that this is due to, among other things, left handers having to operate in an upside-down, back-to-front world, with tools that are, for their purposes, bloody useless, but surely the more obvious explanation is, surely, bands of right-handed people roaming the countryside, looking for “lefties” to re-educate.  In the words of Sherlock Holmes, “when you have eliminated the impossible, whatever remains, however improbable, must be the truth.”  And how many left-handed folk do you know who have died in bizarre present-wrapping accidents involving right-handed scissors?  Less than 20, I’ll wager.

In our wrap up, I learned some interesting big picture stuff that I didn’t know/hadn’t been expressly laid out for me previously.  I shouldn’t even be thinking about returning to any type of work until I’ve completed my rehab at Rusk.  If I went back to work earlier, I’d be at risk of utilizing coping strategies that are likely to be disadvantageous to long-term recovery.  And, it was clarified, if you’ve been referred to Rusk, you’ve had a serious injury.  I was also encouraged to find that my doctor noted, without any prompting, that when one has made an encouraging recovery, and is used to operating at a high level of functionality, other folks may be less likely to notice one’s deficits.  That’s why, according the The Brain Injury Association of New York State, “education of the individual with a brain injury, their family, employer, case manager, and others is extremely important.  If the individual, family, employer and others do not understand the injury and its effects, inappropriate treatment may follow.” To this end, I’ve been referred for a full bank of neuro-psych tests, and ongoing psychology department appointments.

Anyway, that’s enough for now.  I have fights to start and fast cars to drive.  (Editor’s note: Injuries to the right side of the brain can cause decreased awareness of one’s deficits, in addition to the impulsiveness displayed by stroke patients generally.  Oh, the irony.  Stroke Bloke will be back on Monday.  Hopefully.)

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