Speechless.

The click click click of the rotating sprinkler head sang a welcoming song as we made our way from the ambulance to the opened front door of her house. I walked up the paved driveway, spied a deragotory bumper sticker in the back window of an aging Buick, and turned left behind the large pine tree being soaked with water from the automatic sprinkler system in the front yard. Three large flat rocks, resting peacefully on a bed of smaller pebbles, led the way to the front door of the small, yellow house. The crooked house numbers above the screen door welcomed all who entered this warm home.

Inside, directly in front of me, sat a woman in red shorts and a white T-shirt. Red blood, matching her shorts like a paint sample from Home Depot, polka-dotted her white T-shirt with a remarkable style. The elevated hand had been cut while doing the dishes. And the blood seeping from the small gauze provided by the fire department was doing little to prevent its path down her arm and onto her shirt. Soap bubbles still perched on her fingers as if she had been blowing bubbles with a grandchild.

I knelt beside her and introduced myself. She awkwardly attempted to shake my hand. Behind her, and out of her line of sight, the firefighter gave me a brief report. Like in a game of charades, he contorted his face and his fingers to relay a point contrary to what was coming out of his mouth. How many syllables? I thought to myself.

"She said she had a stroke eight years ago," he said clearly expressing only four digits on his hand.

"She said she is 78," he articulated like a robot as he shook his head back and forth in dramatic disagreeance.

Being as sharp as I am, most of the time, I did my best "I understand what you are saying" look and made him feel like the grand prize winner of the family game of charades.

I knelt beside her and started talking. I asked her to explain what had happened and how, exactly, she cut herself.

She took a few small breaths and began speaking. Choppy sentences, like a two year old repeating the cuss words Dad said earlier with his friends, fell from her mouth. She, like the fireman, resorted to body language and began moving her arms and coiling her lips as she tried to express what was happening. Her mind was working, her lips were not.

I immediately slowed down my questions. Someone from the corner of the room shouted she had had a stroke before. I gently touched her knee and had her look only at me so she could reset, so she could calm down and start over. I began talking to her as though she were trapped in a well. I saw a person, and I saw she wanted to communicate, but the exterior shell wouldn't allow her.

"I know you can understand me. I know this is frustrating and very scary. I promise to take good care of you," I calmy told her as the firemen and my partner scurried to get the bed.

"Do you hurt anywhere?" I asked.

She nodded no, then yes. She stammered a few seconds and then blurted out "hand".

She began crying and as tears filled her swollen, red eyes I moved her to my bed and told her what I was going to do.

I barraged her with questions like a nervous prom date and slowly came to the conclusion she was not having a stroke. Her eyes desperately wanted to tell me something and her brain wouldn't allow it. Her words were being held hostage and no amount of ransom could set them free.

As the firemen closed the two doors on the back of the ambulance I sat next to her and did nothing. Everything came to a halt and the hurried actions of everyone around her seized. She slowed her breathing down and attempted to talk, stuttering more than before but successfully articulating words.

"I don't think you are having a stroke," I said as I nonchalantly put the stained blood pressure cough on her left arm, hoping my poker face would work. "I think this is a defecit from your previous stroke."

She nodded emphatically up and down. Her eyes swelled even more, like a teenage girl realizing she got a brand new car for her sixteenth birthday.

"Becuase of all the excitement, you cutting your hand, the firemen coming to your house, the paramedics putting you in their ambulance; your difficulty speaking is more pronounced than usual," I guessed outloud.

She grabbed my hand and squeezed it. She rested her head back and visible weight off her shoulders disappeared. She closed her eyes and slowed her breathing. Words were beginning to form.

"We're just going to sit here for a moment and see if it clears up. I want you to relax and use the oxygen in your nose."

My partner shifted uncomfortably. I knew what was being processed in that other paramedic mind and quickly doubted myself. What if she is having another stroke? What is what I'm doing is wasting time and hurting her even more?

I removed the blood pressure cuff with a quick jerk and tossed it behind my back. I leaned forward and was about to speak when I was interrupted.

"Thank you," she said.

I stared at her and took that opportunity to quiz her more, making sure this wasn't a transient blood clot in her brain and that I was actually correct in my medical assumption.

I asked, she answered.

My suspicions were right on. She told me that due to her stroke she has, at times, difficulty speaking. When she is tired, it is much worse. And when she is scared, it is really really bad. And when she is tired, scared, and overwhelmed with firemen and paramedics in her house, her speech just shuts off.

We pulled into the ambulance bay of the ED and she grabbed my hand.

"Thank you," she said. "Thank you for taking a little time and slowing everything down. If not for that, I'd still be stuttering to you, trying to tell you this is normal."

I stuttered.

She smiled at me, "You see, now you know how it feels."

I was the one that was speechless now.