And then he woke up.

It’s official. As of today and yesterday, Day 47 and 48, Gabe is responding to commands. Not all the time, but in a way that cannot be confused with a simple neurological response (i.e. a hand squeeze, lifting his thumb so it looks like a thumbs-up, pointing a finger, etc). Each of the therapy specialties experienced G in a higher state of consciousness, and his doctor confirms that he is no longer in a vegetative state. “Gabe is waking up.”

Speech pathology (SP) worked with him early on Day 47 and asked him to touch his chin, touch his ear, and touch his left elbow. He did each as requested, the last by finding his left hand and tracing up to his elbow. Physical therapy (PT) also had encouraging luck when giving vocal commands. His mom and I also experienced some things. Around 1pm I was sitting with G, telling him a story about a bicycle ship cruising through space. His forearm was up and he traced his face with his hand. He opened his eyes and I was in his line of vision. His eyes moved back and forth a bit, as if observing, then his hand moved to my face, tracing down to my neck. This was not simply a falling of the hand. It actually felt explorative, a touch that held direction and purpose. He then navigated his hand around my waist. There he rested his arm and hand and I told him he ruled.

So check out what happened with Donna: I had switched over to his left side and Donna came in. He must have noticed her at the edge of the bed. As she swept around to his right side to put her bag on the floor just past his head and outside his line of vision, he released my hand and raised his arm in her direction. His fingers were up and open, and when she stood up,  he took her hand. She leaned down over his chest so we were both in his line of vision and he shifted his eyes clearly from me to her.

The neuro-psychologist was excited when we related these things: there are connections happening in the frontal lobe of his brain where he’s linking sensory input, processing, then responding bodily. He is interacting with people showing true response to voice and/or vision. He is connecting ideas. His movements are not particularly fluid, but the intention is there and easily discernible. To think he may be responding with recognition of the people around him is noteworthy, and it’s significant that the therapists are seeing an equal amount of action from him.

Also on Day 47, two CNAs came in to reposition him in the bed, for which we have to step out. He held Donna’s hand and would not free her. Nearby was his brown stuffed animal moose, Bonzey (named after a friend who sent it to him last month). Silly for a 27-year-old man to have a stuffed animal, but it’s actually great to have the last four weeks because it occupies his hand to prevent clenching or exploration of his trach tube, etc. I placed Bonzey the moose in his lap and he caught sight of it. I said, “Gabe, we have to step out for a moment so hold your moose until we come back.” Whether he understood those words or the moose was visually enticing, he freed Donna’s hand and took it up.

Gabe again brought a heightened sense of awareness to the forefront today, Day 48. When we arrived OT and PT reported the good sessions they had this morning. OT held up a comb this morning and asked, “What do you do with this?” Gabe took the comb and brought it up to his hair. Shortly after, OT uncapped his chapstick and he took it, brought it to his lips, and applied it. Then he rubbed his lips together! Now time for the daily resistance to teeth brushing– perhaps there is a memory of SF General’s vigorous oral care lodged in his gums. When PT got out the toothbrush around noon-thirty, he tightened his jaws and no amount of coaxing would unclench them. Then I said, “Gabe, look, it’s just a toothbrush. Just like we have at home.” PT removed it from the inside of his cheek and he regarded it, then the therapist asked, “Do you want to brush your own teeth?”

…..Drumroll…..

Gabe took control. He reached for the brush and took it from her hand. His lips grimaced back in a curl as we all do while tending to this morning and nightly ritual. He directed the brush into his mouth and set the bristles against his own clenched teeth. PT loosely guided his wrist back and forth; and when I said, “Now the other side,” he maneuvered the toothbrush in reply. Gabe exhibited the will and matched it in body. He eventually released his jaws and brushed his tongue when requested. All by himself.

Gabe’s doctor dropped in after hearing of her patient’s progress and was disappointed each time to catch him in resting mode. Around 5pm Kierie suggested that she tell him about  her BMW.  All she had to say was the 640 model number and his eyes opened.  She added the word convertible and they opened very wide.  She asked for a “high five” and after a delay of seven long seconds–she got one. In the eyes and the words of the therapists and his doctor, he is serving up more than just reflexive movement.

From the home front, Donna and I are well and at ease. We move tomorrow north of the Golden Gate Bridge, within walking distance of the hospital. Summer is now back in Maine after a good week+ out here, and she has Gabextravaganza party happening this Friday night in Bangor. There’s a ton of prizes and cupcakes and such, and the promotion work she’s done trumps marketing efforts of the top executives in any advertising agency. We’re excited for Mike to arrive this Friday, and look forward to relaxing on the deck of our new—albeit temporary—home whilst overlooking  the end of a California summer and the sparkling  lights of Marin County.

Click your toes and clink your beers. Gabe is on his way.