Suzanne GoldenbergFriday July 11, 2003
His first word was "mum". "Pepsi" followed soon after. There have been a couple of unmentionable phrases as well. Nineteen years after the car crash that left him in a coma and paralysed from the neck down, Terry Wallis is slowly rediscovering the art of conversation.
He is not yet one for striking up an exchange, and his speech can be difficult to understand at first, slow and without inflection as he struggles to form the words. But he readily responds to an introduction, saying: "I am Terry," and spells it out for additional clarity.
Angilee Wallis, his mother, looks on, hazel eyes positively blazing with pride. Tammy Baze, his younger sister by a year, leans over the bed, coaxing the words out, and he proceeds swiftly through the formalities. When asked how he is doing, Wallis is forthright. "Horny," he says.
Angilee is mortified. Tammy leans even further over the bed, fierce now: "You know you are not supposed to do that," she says.
Nobody had really expected Wallis ever to talk again. When they recovered his body from a dried-up river bed, after a serious car accident in June 1984, the doctors warned Angilee that her first-born son might not live beyond a few hours, so severe was the extent of his brain-stem injury.
For weeks, he remained absolutely lifeless. For months or years - over the course of nearly two decades the details have blurred for his family and carers - there was little more than a blank stare. Now, just a few weeks after his wondrous first utterance on June 11, it is hard to know just what he is going to say next.
His voice is flat, his brown eyes roam, and his face does not appear capable of much expression. He has problems with short-term memory and, as noted, with some rules of social behaviour. He remains unable to move below the neck, of course. But for Angilee, mostly it's been unalloyed joy.
Much of Wallis's conversation is prompted as Angilee and his sister drill him to recite his birthday, a favourite saying of his long-dead great grandfather, or to recall one of his childhood escapades. But he is capable of speaking short sentences, and of spontaneous responses and wit.
"He's always been a big kidder, but now he is all the time teasing somebody about something," says Angilee.
The Ozark mountains, where Wallis grew up, are isolated terrain, with stunning scenery and grinding poverty, but rich in folk music traditions. The town of Mountain View, where Wallis has been in the Stone County Rehabilitation and Nursing Centre since 1985, has one traffic light and a population of 2,876. On summer nights, people take folding chairs down to the court house to pick on guitars and sing. Wallis likes music too - except rock. "I don't like rock and roll," he says, spelling out the words again. His favourite, he says, is Johnny Cash - a surprise for Angilee and Tammy.
Music has been a touchstone for Wallis as he slowly found his way back to consciousness, and communication. In the past few weeks, he has watched the country music station almost constantly. He can read material held up to him. But he shows no interest in other television channels, and does not appear at all engaged with the present.
Though he can reel off his date of birth, Wallis is at a loss to say how old he is, despite his sister's prompting. He also has almost no recollection of his life immediately before the crash. He was just 20 years old at the time, a newlywed, with a six-week-old daughter. A high-school dropout, he scrabbled to make a living fixing cars.
He does not remember his wife, who moved on with her own life years ago. At times, he refuses to accept that he has a daughter, who is now nearly as old as he was at the time of the crash. But he can remember his brothers and sisters, and childhood squabbles over responsibilities for chores on the family's small farm (Wallis fed the pigs).
He also remembers his mother, the anchor of his memories of his life before the crash, and the one true believer in his ability to recover.
Wallis had been travelling in a pick-up truck on one of the treacherous roads that twist and turn through these mountains when the vehicle crashed through a guard rail, and flipped over into a dry creek bed. By the time he was brought to hospital in the neighbouring state of Missouri, the doctors were telling Angilee to prepare for a funeral.
"When I saw him, they tried to prepare me for all the tubes," Angilee says, shaking her head. "But when I got there, and I saw his hand moving, I thought: 'Why, that's good.' But I didn't know that that meant brain damage."
It was weeks or months before Terry's eyes opened, and by the time he was transferred to his present home in 1985, it was generally accepted that he would never emerge from his coma, never show any signs of improvement.
But not by Angilee. By the time Wallis arrived at Mountain View, the medical community had decided that he had virtually no hope of recovery. He has not been seen by a neurologist since his physical condition stabilised after the crash. He received no speech therapy or other specialised therapies until after he started talking last month. He has yet to be seen by specialist physicians since he regained some speech.
There are no absolute standards between stupor, persistent vegatative state and the other states between profound coma and consciousness, says Jeff Victoroff, associate professor of clinical neurology and psychiatry at the University of Southern California's Keck School of Medicine. He reads from the neurologist's bible: "The limits of consciousness are hard to define." He also says that while it is rare for someone to emerge from a profound coma, or a persistent vegatative state, it does happen. "It's astounding, but it is not unheard of," he says. However, he says it is virtually impossible for someone to regain the full extent of their cognitive abilities.
Wallis regained some powers of speech when Angilee arrived on one of her visits. An aide, coaching Terry, asked who it was. He said: "Mum", astonishing both women. He went on to call the aide by name, "Pam", and, on Angilee's coaching, went on to say the word "Pepsi". His family took him home for a visit that weekend, and the words kept coming. Within less than a week, he had moved on to short sentences.
"Now he won't quit talking long enough to eat," worries Angilee. The effort makes him wheezy. "I will quit talking to eat," echoes Terry.
Wallis's family and his carers, are hazy about when he first started to blink, and when those blinks first seemed like an attempt to communicate. He is the longest-serving resident of the home, which is mainly for the elderly, and recovery appears to have arrived at an almost imperceptible pace. Over a period of years, he developed the ability to track movement with his eyes. More recently, he began to grunt in response to questions - or at least Angilee was convinced of it.
Dr James Zini, the director of the nursing home, was not. "I felt that he had a blank stare, that he would probably respond to painful stimuli, like pulling on his ear," he says. No more beyond that. But then, he acknowledged: "I never objectively saw everything she saw, but then neither did he respond to me the way he did to her."
Since Wallis first spoke, Zini has taken to carrying a pocket-sized guide called the Glasgow Coma Scale, which seeks to calibrate consciousness. Zini, looking back, says he would have placed Wallis about midway through the scale, hovering around the edges of awareness. "In retrospect, now that he is able to talk to us, he actually was more aware than we realised," he says.
There are absolutely no signs of rancour with the hospital administration. Angilee introduces Dr Zini as her friend, not the doctor. But she believed. Twice a week, she drove the 50-mile return journey from Big Flat to the nursing home to see her son, and she did much of it alone. Although Tammy was often there, her husband, James, is not one for hospitals, and neither are Terry's two brothers. On alternate weekends, and on Christmas and other holidays, the family took Wallis home to Big Flat. His hospital bed and other paraphernalia dominated the sitting room of their small two-bedroom house for years. "We tried to talk to him to get him responsive, to take him to familiar places and familiar people," she says. She talked to him, wheeled him around, read - Wallis says that he remembers the reading.
She can't really say how or why she kept going, beyond the fact that Terry is her son. It has not been easy. Angilee works the occasional shift at a factory making shirts for US navy uniforms; husband James looks after the farm. Although the family originally had a van with a wheelchair lift, it broke down some years ago, and they have taken to hauling Wallis from nursing home to car to house. Although she describes herself as a believer, she is not a churchgoer, and wasn't driven by faith of a miraculous complete recovery.
"I wanted to keep on talking to him, and taking him home. It just got to be routine. It is what we did, but I can't say I really thought he would get better," she says. "It just got to be a routine."
Now the family must figure out an entirely new routine. Dr Zini is wary of pushing him too quickly, and the family is unclear how to fill in the gaps between 1984 and the present as Terry's memory and vocabulary expands. But Terry appears to have no fears. "Anything I want," he says. It's one of his favourite phrases.
While you were sleeping: what Wallis missed
Politics Ronald Reagan is no longer president of the US. That's George Bush. No, not that one, his son, George Jr. (Relax, he's not drinking any more.)
President Konstantin Chernenko of the Soviet Union is dead. In fact, the Soviet Union is dead. Oh, and the cold war is over (we won) and the Berlin Wall no longer exists. Castro is still going strong, though.
The US no longer has troops in Lebanon, but it has intervened in Libya, Panama, Saudi Arabia, Somalia, Yugoslavia, Iraq, Haiti, Sudan, Afghanistan and Iraq (twice) while you were sleeping.
Ask someone about Osama bin Laden.
Music Prince is no longer at number one in the US singles chart with When Doves Cry. Ray Parker Jr, of Ghostbusters fame, is no longer, so far as we know, a popular musician. Wham, who released a song called Wake Me Up Before You Go Go a few months after your accident, have split up. Oh, and George Michael is gay. So is Elton John, for that matter. And that bloke from Frankie Goes to Hollywood. Liberace was too, but you knew that (he's dead, however). And so was Freddy Mercury, but he's dead too, alas.
Someone should tell you about Aids, but perhaps we'll let you recover a bit first.
People Lady Diana had another son, called Harry. He enjoys polo and other activities on grass. She died, however, and Prince Charles went back to his old girlfriend.
John Kennedy Jr, Indira Gandhi and Mother Teresa are no longer with us, but they freed Nelson Mandela.
Michael Jackson is now white, Madonna is now English, and Paul McCartney's hair is now aubergine shimmer.
Technology Apple Macintosh, which was introduced early in 1984, has gone on to be quite successful. At the time of your accident, there were about 1,000 hosts on a thing called the internet. That has proved quite popular as well.
Phones are now mobile, discs are now compact and computers are now personal. You can still get digital watches, however.
Culture There was a terrible famine in Africa shortly after your accident, which concerned the world of pop greatly for a week or two.
They discovered the Titanic, and Cherry Coke.
It is no longer cool to dance the way they do in Footloose. Mullets and stonewashed jeans are unacceptable.
Victoria Principal didn't marry Mark after all; she woke up and found Bobby in the shower and realised it was all a dream. Falcon Crest has been cancelled.
Jogging is, like, so over. Esther Addley
