Beauty in the Broken Places: Memoir of Love, Faith, and Resilience

Dr. Pickard:
Five months pregnant on a vacation flight to Hawaii, Allison Pataki turned to her husband and watched him suddenly lose consciousness.  After an emergency landing in Fargo, North Dakota and subsequent extensive evaluation in Chicago, this 30-year-old athlete and surgical resident is diagnosed with a rare bilateral thalamic stroke.  When Dave Levy wakes up, he has amnesia, and Allison begins writing letters to Dave, which become the basis for the book Beauty in Broken Places:  A Memoir of Love, Faith and Resilience. 

I’m your host, Dr. Maurice Pickard, and you’re listening to Book Club on ReachMD.  And with me today is Allison Pataki, who is also the bestselling author of several novels.  Thank you very much for coming today and talking with us. 

Ms. Pataki:
Thank you for having me, Dr. Pickard. 

Dr. Pickard:
So, what was the motivation to begin with for writing this particular book? 

Ms. Pataki:
Absolutely.  So, as you mentioned, I was a writer by trade, Dave was a surgeon, and we were heading on this flight, actually, for what you call a babymoon.  We were about to become parents.  We were on the cusp of this new season in our lives, and this was sort of the last trip we were going to take together as a young, married couple before children changed life forever, and that’s when Dave had the stroke, was midflight, 35,000 feet in the air.  And obviously that was not anything that you prepare for or that you expect to happen in the way or in the moment that it happens. And so when Dave woke up from the coma several days later, he was less functional.  My healthy, 30-year-old doctor husband, lifelong athlete, his brain was so severely traumatized by the stroke that he was less functional than a newborn.  What are the first things a newborn can do?  They cry out, they use their lungs, they breathe, they make noise and they swallow, they have their first meals from their mother, and Dave couldn’t do any of those things.  He couldn’t speak, he couldn’t communicate, and he certainly couldn’t understand, and he couldn’t understand what had happened to him and to our family.  And the person I needed to most speak with going through this experience and just the fear and the agony of the unknown and just the complete and total chaos and disruption of the crisis was my husband.  That was my partner, and I couldn’t speak to him.  He wasn’t there, you know, physically, mentally, emotionally. 

And so what do I do?  I’m a writer, so I went to the written word and I began writing him these letters, and I just knew in those crazy days in the ICU where Dave couldn’t carry any memory and where I was so overwhelmed and so just in over my head, I knew I couldn’t count on myself to remember everything that was going on, and so I processed it through writing.  And I just thought, gee, wouldn’t it be so wonderful if some day Dave returns to me and is well enough to understand and to have questions and to wonder what happened, and I can write him these letters and he can come back and read and he can know what he went through, what we went through, and maybe through these letters and through this story I can make the memories for him and we can begin to heal together? 

Dr. Pickard:
Did those letters and that experience lead to this particular title:  Beauty in the Broken Places? 

Ms. Pataki:
Yeah.  And, you know, Dave is an orthopedic surgeon.  His livelihood every day was in dealing with the broken places for others, for patients, literally fixing broken bones, and so this was such an upheaval for him to have the table flipped and to go from being the healer and the doctor to now all of a sudden being the completely helpless, incapacitated patient, and he really was seeing medicine and healing from a completely different perspective.  And where we came up with the title was there’s this quote, “The world breaks everyone, and afterwards some are strong at the broken places.”  This experience really did break us in the sense that everything about our lives was pulled out from under us.  Our plans, our lives to go and become parents, enter this new phase of Dave’s career as a doctor, this career that I had as a writer, the life we had sort of thought we had mapped out, the illusion of control that we thought was ours, that was all changed in the blink of an eye, literally, when Dave blinked his eyes and lost consciousness.  And so then the question became:  As we strive for recovery, as we strive for healing, how do we recapture hope and beauty and love and faith even at this low moment where it seems like everything we had planned for and sort of banked on and worked towards has been ripped from us and where we’re saying we’re really going to need to rebuild now as a family from a place of like zero? 

Dr. Pickard:
One of the questions I was going to ask you later, but you’re almost leading into it, was:  Earlier in your story, you alternate between this, I have so say, almost idyllic courtship that you and Dave had—you begin to meet each other in college, both of you are exceptional in many, many areas—and you alternate this beautiful courtship back and forth with what’s going on first in the emergency room in Fargo and what later happens at Rush Hospital in Chicago and in rehab, and you alternate back and forth.  It’s almost jarring to the reader.  Why did you use this particular narrative? 

Ms. Pataki:
Yeah, so Dave and I have been together since we were 19 years old.  We started our courtship, as you said, in the fall of our sophomore year at Yale, and in many ways we acknowledge we had a charmed few years as a young couple.  And the story for all intents and purposes with the memoir begins right around the time when Dave loses consciousness at 35,000 feet in the air and I lose the Dave I loved and married and started a family with, and so the thought was sort of like, okay, the reader doesn’t really get any chance to get to know Dave because he falls asleep and he’s gone, and for the whole rest of the memoir you don’t know if that man is ever coming back.  I didn’t know if that man would ever be back, the man I married, the man I loved, so the thought was we need to give some context into the life, the relationship, the choices, the decisions, the journey that got Dave to this point of then losing consciousness and losing his identity and waking up in a state of amnesia.  So we give those sort of flashbacks to provide some context and shed some light on who Dave was and who the Dave was who was lost in the stroke, and also just it’s a really...  You know, it’s not easy.  There’s a lot of pain in the stroke and the fear of:  Is he going to wake up  And then when he does wake up, who is this man who has woken up?  This is not my husband.  This is an amnesic shell of the former man I knew.  And so we thought give the reader a bit of a break in between these really intense neuro ICU moments by inter-slicing in a little more levity and a little more of the lightness which is sort of the backstory of our courtship and our lives prior to the stroke. 

Dr. Pickard:
You talk about the plasticity of the brain, how the brain begins to heal, and we know that scientifically, but here you are sitting next to a person and you have to almost accept that on faith that something is taking place in a healing way, but you can’t see it.  It’s not like, you say, a broken bone or a scar after surgery.  You have to accept it on faith that something is taking place, that a marvel is taking place that will alleviate some of the frustrations that you’re experiencing at the bedside.  How do you accept that? 

Ms. Pataki:
Oh my goodness, and more than frustration, just agony and excruciating pain and fear that this man’s brain is so battered he’s gone.  And neuroplasticity was something I had not heard of.  I did not know this concept of the brain being plastic until the stroke, and then I heard—that became our buzzword.  That became our mantra.  The brain has this remarkable capacity to heal, to adapt, to adjust to injury, and that some of the pathways, some the train tracks, if you will, in Dave’s brain have been completely bombed out, but the brain will have the capacity to form new train tracks, to get those neurons back up and running, and it was remarkable to see.  As I said, Dave went from less functional than a newborn…  He had to literally regrow his brain through every phase of maturity. And what was so interesting, fascinating, sort of overwhelming to witness was that while my 30-year-old husband was going through this process of regrowing brain cells or reforming neural pathways and connections, I then had a newborn several months after that stroke, and a newborn’s brain is incredibly plastic as well, so I’m seeing in my household and in my family my 2 closest loved ones with these plastic brains and these minds that are forming and changing every single day, and one of them is my husband and one of them is my new daughter.  It was really remarkable.  And there are frustrations.  Obviously, when you’re watching a newborn brain grow and evolve, you have so much joy and pride as the parent and you know it’s happening.  You know that your baby is growing and learning.  With your partner it’s a little bit harder, and as you said, you do have to take more of it on faith, because you didn’t marry this person to take care of them as you would a newborn.  You married this person as your partner and as your loved one and your equal, and so it really kind of changes the dynamic in the marriage and in the household.  But as you said, you take it on faith. 

The brain has this nebulous, difficult-to-understand quality.  As you said, there’s the element of the unseen.  But the flipside to that, which is such a positive, is that it has this miraculous ability to heal in a way that’s unlike any other organ, muscle or piece of the body, because it is so...  Things are happening that are unseen that we can’t really even scientifically or in any linear way define.  The brain just works these miracles.  And even our neurologist had to leave a lot to just saying, “Do the therapy, get rest, get good sleep, get good exercise, and let the brain do its miraculous healing work.”

Dr. Pickard:
If you’re just tuning in, you’re listening to Book Club on ReachMD, and I’m your host, Dr. Maurice Pickard.  And joining me today is Allison Pataki, who is discussing her memoir, Beauty in the Broken Places:  A Memoir of Love, Faith and Resilience. Many of the people in our audience are physicians, nurses and other caregivers.  Reading your book, would there be some special message that you could give them that would help them move forward in the challenges that they all face? 

Ms. Pataki:
Yes, this experience, I think, most profoundly taught my husband—who is also a doctor, who is a physician, who is a surgeon—is it taught empathy in a way that I don’t think any previous experience could have possibly done, just because he knew the importance of empathy and bedside manner and putting himself in the place of his patients, whether they be scared, angry, sad, frustrated, whatever that emotion would be, he could try to understand that, but then when the roles were reversed and he was suddenly thrust into this role of helpless, scared, sad, lonely, angry patient, etc., whatever adjective you insert depending on the day, it gave him an understanding of vulnerability, I think, and empathy and just what a thin veil there is between the control that you have every day as a capable, healthy, young doctor or just any capable, young, healthy individual who more or less feels that they are steering the ship of their life and feeling like you lose that control.  I think Dave, ever since then, ever since the experience of the stroke and the recovery, he’s got a sort of softer, more tender side for the patients because he can so easily now put himself in their shoes, and he knows when he’s speaking to a stroke survivor or a brain injury survivor, he knows the fear or just whatever the sense of injustice or the sense of loss or the sense of pain, whatever it is; he can so clearly identify with that.  And so I think it’s just treating the patient as a whole human and understanding there’s so much more to being a patient than just the physical manifestation of the injury. 

Dr. Pickard:
So you’re speaking really to the need for this doctor-patient relationship, which now the electronic medical record seems to be interfering with, but I guess that would be a topic for another discussion.  You mention a quote though that I had heard before by Viktor Frankl, well-known psychotherapist and a Holocaust survivor, and he says, “Suffering ceases to be suffering at the moment it finds meaning.”  How did this apply with you and Dave? 

Ms. Pataki:
I think this applied in many ways just in terms of the way we did as a family and then also individuals a complete reevaluation of what life’s meaning is and sort of what our priorities are, and I think Dave on the one sense… I think we sort of wake up every day with, perhaps, a little bit of fatalism or PTSD, not in a bad or oppressive way, but just we are aware that the bad thing can happen.  We have lost sort of that illusion of control, and we know in a really great moment like we enjoy this moment.  Enjoy this moment because there’s hard things and there’s happy things in life and you must enjoy the good.  But I think it’s just given us a greater sense of appreciation.  For instance, we were pregnant with our first daughter when Dave had his stroke.  He almost didn’t get to know his daughter.  Our daughter almost didn’t have a father.  The family we had planned on very, very well might never have happened.  We’re now pregnant and expecting our second child 3 years later, and when we hit the moment in the pregnancy that was the exact day that Dave had the stroke in the first pregnancy—I was 22 weeks and 1 day when Dave had his stroke in the first pregnancy—we hit day 22, 22 weeks and 1 day this time and Dave just wept, and these tears of just gratitude, I would say, and just joy and just breathlessness at how close he almost didn’t come to getting to experience this.  And I think that he just takes like a deeper meaning and deeper appreciation in those moments in life and just thinking he gets a second chance.  That’s an amazing, amazing experience to kind of reckon with at age 30, to think, “Okay, I almost lost all of this.  I almost lost this life.  But now I’m back and I’m living and I’m in recovery.  What am I going to do with this second chance at life, with this second chance to be a husband, a father, a man, a person, an individual, a friend, a son, a brother?”  And so I think it gives you a really, really kind of deep appreciation and awareness for life. 

Dr. Pickard:
During this journey, you go through tremendous amounts of various pressures from different areas that we can only guess at, but there comes a time when you feel the need to ask for help.  It is so difficult for certain people, maybe all of us, to ask for help.  How do you know, “This is the time when it’s okay for me to reach out;” “it’s okay for me to cry;” “it’s okay for me to call my best friend to come over and help me”?  How do you know so that our listeners can respond to it and say, “It’s okay”? 

Ms. Pataki:
Yeah, and I really struggled with that because, as you said, I had a hard time sort of breaking myself open and showing my vulnerability and sort of presenting to the world just this raw need that was sort of stripped of the veneer of self-sufficiency.  Prior to this event, I had sort of deluded myself, maybe you could say, or prided myself in thinking that I more or less had it together, whatever it means, but I could more or less get through the days, and this is the first experience where I have a husband who was so sick, I had a newborn, I was trying to keep our lives afloat, keep our household afloat, keep my career afloat, wondering if my husband would ever have a career, to be the breadwinner, the caretaker, the provider, the nurturer for my family, and it was too much.  My body was just stripped, and mentally, emotionally, physically I was just completely drained.  I started to really struggle with insomnia, and I started to struggle with anxiety and depression.  And really, fortunately, when I was at my limits, that was when my tribe had to step in and say, “You cannot continue to do this on your own.”  And what I learned about this was like the importance and the grace that comes in a crisis when people just show up for you and they know there is such grace and mercy in just showing up and saying, “I’ll hold your newborn for an hour; go take a nap;” or, “Here, I’m showing up with groceries,” or, “I’m showing up with dinner.”  It can be really hard to ask for help, but I just think it’s so important that you have those outlets that you can go to, as you said, that you can call and cry or ask for help. 

And then you just know, hey, this is a season of life.  This is not forever.  Today is not forever.  I’m in a position now where I need and where I’m calling on people and I feel like I have to take maybe more than I’m comfortable with, but I will get through this season, and I will get through another season in life where I can give back again, and I want to be that person when my loved ones need and need me, and I will show up for them the way they have showed up for me.  No one is an island, and that’s what you really learn through crisis is just that you have to call on support, you have to rally the troops just as you would want to be there and show up for your loved ones when they need you. 

Dr. Pickard:
Before we leave, and I think it would be appropriate to leave, to tell our listeners that Dave wrote the epilogue to your book.  And if Dave was on our show or on our interview at this time, what would the two of you say in closing to our audience? 

Ms. Pataki:
Absolutely.  So everyone wants to know, “How is Dave?” and, “Where is Dave today?”  And so we figured why not let Dave answer that in his own voice?  And so Dave wrote the epilogue, and he answered that question.  And the answer is he’s wonderful.  You wouldn’t believe, I wouldn’t have believed if you told me 3 years ago… because the stroke was almost exactly 3 years ago from June.  It was June 2015.  I would never have believed the miracles that would have been possible in his healing and in his recovery.  So he loves being a father.  He’s so excited to become a father again.  He takes tremendous joy in his family.  He’s back at work.  He left orthopedic surgery.  He left the residency; just the lifestyle was not possible to maintain while in recovery from a stroke.  But he segued into medical consulting now, so he still gets to draw on so much of what he loved about medicine and being a doctor, but he’s just applying it, I think, in probably a more humane lifestyle and career choice, and I think he just has a wonderful sort of newfound appreciation and perspective. I worried when he left orthopedics would he feel like he had sort of been robbed of everything he had worked towards for a decade and the career of plan A, plan A that he always thought was his, but he said he wakes up every day without regrets.  And quite frankly, I think he’s happier than I’ve seen him in years, and so I think the stroke in some ways was just this miraculous opportunity to have this chance to sort of step back and say, “Okay, now is my time to reevaluate.  What do I want to do?”  And so I think he’s in that process, and I think we are all… I think every day we have questions and we have the choice to say, “How do we want to live this life?”  I think he’s in that sort of phase still where he’s thinking, “Plan A is no longer happening; I’m no longer an orthopedic surgeon.  Life is about how you handle plan B.”  And I think every day that’s sort of an ongoing discussion and negotiation you have with yourself, but he feels very lucky that he even gets to consider those questions and think about that. 

And he’s very good at being present and in the moment, and I think that’s something that I know I need to be more aware of, but I’m aware that I need to be in the present and the daily sort of struggle that I want to kind of maintain.  I want to be present for our daughter.  I want to be present in our lives.  I want to be present in our family.  And I think that’s really the big thing that we sort of learned and taken from this is just have an appreciation for every single day.  As cheesy as that sounds, we know how close we came to not having these days together, and so now that we do get to have them, let’s just choose to live them in the best possible way for one another and for ourselves. 

Dr. Pickard:
Thank you very much.  I think for all of us who want to live in the moment and really savor everything that has been given to us, reading Beauty in the Broken Places is something that all of us should be reading.  So thank you again, Allison, for joining us.  I look forward to your next book. 

Ms. Pataki:
Thank you, I really appreciate it, Dr. Pickard. 

Dr. Pickard:
This is Dr. Maurice Pickard, and if you have missed any of this discussion, please visit ReachMD.com/bookclub to download this podcast and many others in this series.  Thank you all for listening.