Brooke's Brain

It was already pitch black outside at 5:00 pm on a Tuesday evening. I used my cell phone light to illuminate the pavement as I made my way down the long driveway. The house was large and stately; it was hard to tell which door was the main entrance. I picked one and knocked tentatively.

A small woman with wiry blond hair opened the door.

“Hello, I’m Kara, the speech-language pathologist with Gladeview Hospital Homecare,” I rattled off my introduction.

My boss Jennifer had called me, desperate. We have a homecare patient. Can you take her?

I had hesitated. I was already working over 50 hours a week at the hospital, between inpatient and outpatient. Burnout was a very real possibility.

She’s a high school kid, Jennifer implored. Seizures.

I thought of my little cousin Gemma, her thick strawberry blonde hair and bubbly personality. She was a sophomore in high school, captain of the hockey team. I agreed.

“Kara, hello.” The woman was wringing her hands. “I’m Heather, Brooke’s mom.” She pulled the door open wider. “Please, come in.”

Heather directed me through the kitchen, which led into the living room. A large brown couch lined the back wall, a row of windows behind it, a thin girl curled up on its left arm.

I made my way to the couch and sat down in the middle. Brooke turned slowly to face me and smiled sweetly. Her dark blonde hair was in a bun, greasy and matted, likely from EEG electrodes.

“Hi Brooke.” I smiled. “I’m—”

“Brooke, honey, this is Kara. She’s a speech therapist. She’s going to work with you, ok?” Heather scurried over to her daughter and started fussing with the couch in an attempt to put the recliner back down.

“Mommm, stopp.” Brooke’s speech was slow and effortful. She brought her hand up to swat at her mother, but it moved in slow motion. Heather wrung her hands. “Sorry, I’ll leave you two,” she said, and hurried into the kitchen. “I’ll just be right over here if you need anything!” She called.

“Hi Brooke,” I started again. “I’m going to be coming over after school to work with you.” Brooke nodded slowly, a lethargic smile curving her lips. I opened my mouth to go on, but stopped short. Brooke seemed focused, her lips pursed. After a few seconds, she breathed. “Soundds goood,” she said.

“Tell me about your life before the seizures,” I prompted. I needed a spontaneous speech sample. Brooke smiled and took a deep breath. “Before…thhhe—”

“Brooke was a straight-A student,” her mom jumped in. I hadn’t even noticed her creeping closer to the living room from her spot in the kitchen. “Played varsity basketball.” She smiled at Brooke. “Right, honey?” Brooke nodded, looking at me. Her mom continued. One day, Brooke had a seizure in the middle of class. She was rushed to the hospital where she stayed for nearly two months. She continued to have seizures, and the doctors couldn’t figure out why. They tried a host of medications, but nothing seemed to help. Finally, they found a drug cocktail that seemed to calm her brain.

“But the speech and word-finding deficits persist,” I murmured to myself.

“Brooke was in AP classes at the time. Now, she’s in special education. She can only handle a half a day of school because it’s too exhausting. She’s working on first grade math and reading.”

Brooke looked at me as her mom talked. Her eyes were soft but distant. I noticed the glisten of tears as they started to well up. I held my hand out. “You know what?”

Heather stopped.

“Let’s do something fun. You want to play a game?” I looked directly at Brooke, who nodded slowly. Then, she took a deep breath. She pursed her lips together and pushed down hard.

 “Mmommm, I haaaave…to go…” Brooke lifted her arm slowly and pointed toward the door.

“The bathroom? Sure,” Heather swooped in, gesturing one second.

“Take your time,” I said. I whipped open my laptop and started typing. Patient is a 15-year-old female presenting with seizure activity of unknown etiology. After a lengthy hospital stay, she was discharged home on Keppra and has been attending school part-time for the past three weeks. Speech production is characterized by

My typing comes to a halt as I hear screams from the bathroom.

“Kara, call 911!”