Saturday, April 15, 2006

The Patient Is Awake and She's Working Blue

"God grant I never die in a fucking hospital! Let me die in some louche bistro, a knife in my liver, my skull split with a beer bottle, a pistol bullet through the spine, my head in spit and blood and beer. . . . Or let me die in an Indian hut, on a sandbank, in jail, or alone in a furnished room, on the ground someplace or in an alley, on a street or subway platform, in a wrecked car or plane. . . . Anyplace, but not in a hospital, not in bed . . ."
—William S. Burroughs, "Lee's Journals," Interzone

TWO DECADES AGO, WHEN my maternal grandmother had a stroke, my mother and grandfather waited with her to receive a visiting doctor. When he arrived, he asked, as most doctors doing rounds will, "How are you feeling?"

Through her stroke-slurred speech, my grandmother still managed to make herself very clear: "Like shit."

Proving herself to be her mother's daughter, this is exactly what my mother said when I asked the same question this morning.

My dad and I arrived around 9:30. The hospital had called him with news that my mother had been moved from the recovery room to a comprehensive-care unit, one step down from recovery but with nurses on hand for those with longer recovery times. In my mother's case, this stemmed from her compromised lung function, which made the comedown from the anesthesia something of a bitch.

She was sleeping fitfully when we arrived, tubes connected, monitor beeping, gauze and tape barely covering a broad, livid bruise along the swollen right side of her neck. I didn't want to wake her up, because I thought that the more recovery she could undergo while not being awake for the associated pain, the better. After about 10 minutes, though, her eyes fluttered, and I moved into her field of vision. Thankfully she recognized me instantly. She further proved her quickness of mind by responding as I mentioned above to my query about her health.

Her voice was rough — from being intubated for oxygen while under, or just from the knockout gas itself, I didn't know, or ask. She was clearly in pain, and not just from the incision; her lumbar condition and sciatica were in full blast from having been on her back for hours. Also, the hospital apparently went to Percocet as their painkiller of choice, which, for my mom — who is under the care of a pain-management specialist — is like Skittles. Added to that, she had to hit the ladies' room, or its portable equivalent. So she was in pain, had to pee, and feeling depressed. "If I'd 'a known I would feel like this, I never would've had it done," she said. I understood her sentiment, but I didn't say anything, while she was dazed from a night of on-and-off sleep and a double lungful of anesthesia, about the Aces I had in the hole: the two photos of her arteries that I had with me.

A nurse fortuitously picked that time to check in, and we let her know of my mom's needs. (Mom did later say the nurses on this floor had been very pleasant and helpful, always a plus.) She was there to prep my mom for a move to a semiprivate room, after the surgeon stopped. She began to remove some of my mom's bandages, including the heavy packing around her throat, and some of the tubing — each in its way traumatic to sensitive or recently incised skin. I held my mother's hand as she winced. The monitor beeped insistently as her heart rate spiked with the pain. It was at that time that the Burroughs quote came to mind. I know I would have traded places with my mom in a minute to spare her further suffering, even as incidental to necessary work as it might have been, but as for being hospitalized myself someday . . . let the scythe fall and the Reaper take His due.

The doctor arrived about 15 minutes later. He kept things light, but he said he was no rush to release my mother if she still felt weak the next day. (Someone my age, presumed to have greater resiliency, probably would have been booted by now, as this is viewed as an outpatient procedure. My response would have been to handcuff myself to the bed.) He was pleased with her responsiveness, though, laden with sleep debt as it was, and reminded her of how much she needed the surgery she had once tried to cancel. That was my cue to produce the photos. I'm not sure which one stunned her more, but they did evoke a "Holy shit!" and a change of heart regarding whether the pain and inconvenience of recovery was worth it.

About an hour and change after we arrived, Mom was moved up to the top floor of the hospital to a semiprivate room. She had been stationary so long, and her cramping back and hip were giving her so much grief as a result, that getting out of bed and then inching onto the stretcher was a deliberate, measured process. But once we were mobile, it was a quick trip. As a bonus, the second patient was moved out of the room a quarter hour after we arrived, and so the place was ours.

Here, Mom was not only able to convince the nurse to get her another two Percocet, but she was served lunch. I returned from the bathroom to find her sipping some egg drop soup, and a platter on the tray held a grilled chicken sandwich and broccoli spears. The broccoli she could give a damn about, but she set upon the chicken breast with a fervor, dropping the bun in the soup and tearing the meat up to eat it piece by piece. We chatted with her about this and that, even though not much had happened between yesterday afternoon and this morning, just to keep her mind off of her pain while she waited for the pain pills to arrive. Her voice was sounding stronger, and her mood was elevated from earlier. And clearly her appetite had recovered!

My dad and I took a break to get food of our own. Before we left, Mom directed us to look for pastry — "Prune danish," she specified. I saw an apple turnover that looked so-so, which led me to ignore it and grab her two of her favorites: M&Ms and Smartfood popcorn. I figured if she wasn't able to eat one, she could go for the other. Unbeknownst to me, my dad snagged the pastry. Mom did confirm that she couldn't eat the popcorn while in the hospital and away from her floss, but she drooled at the turnover and the M&Ms, which she attacked immediately. By this point she had also gotten the pain pills from a nurse. Selecting the chocolate morsels from a plastic cup, my mother proclaimed, "I have my family, my Percocet, and my M&Ms, and the rest of the world can fuck off." Hear hear.

We left her sitting in a high-backed chair, which was easier on the sciatica than lying in bed. I pointed out to her that I had brought her usual Friday Wall Street Journal crossword puzzle, along with her glasses. But by that point, from the food, the lousy sleep she'd had last night, and maybe the Percocets, she was nodding off again, and she told us we didn't have to hang out all day if we didn't want to. Typical Mom, not wanting to seem a burden. We kissed her goodbye, told her we'd be by the next morning, and headed out.

My dad gets quieter than usual in situations like this, and has a tendency to pull into himself and seek the comfort of the familiar. I tried to get him to come to dinner with me at a local diner, but he really just wanted to be home, where he could grab a drink and not dress up — though what that might constitute for a quick trip to a low-formality greasy spoon, I dunno. But I know not to keep prodding him when he is looking for a corner, so I left him at his house, reclaimed my car, and headed back here.

I took a walk into town, my dry cleaning under my arm, in uncharacteristic 80ยบ weather and skies finally blue after a morning of fog. It gave me time to think, even amid what seemed like half the town out enjoying the weather. The plans my parents have to get the main floor of the house switched over to holding a bedroom probably need to be thrown into higher gear. Mom is not going to want to screw around with stairs as much as it can be avoided, until she gets her wind back and is both less stiff and back on her usual pain regimen. She can sleep sitting upright on the couch in the short run, and the more sleep she can get, the better she'll heal. But I know they're both looking forward to cutting the stairs out of the equation as soon as they can. My father can handle the basement stairs well enough for laundry duty, but even he slows down at the lean end of the day.

I don't know if my mother will make any deep changes in her lifestyle based on this experience. The photos of her carotids seemed to make an impression. She had been given a nicotine patch, which was probably the only reason she wasn't clawing the sheets off the bed when we arrived. I would love to see her quit. Too often, though, my father — who quit cold turkey 25 years ago — resorts to sarcasm when my mom mentions cutting back, and provides little support. I can't have that attitude poisoning what might be her last chance to make a difference in her quality of life by quitting. I don't care if she papers herself in patches and chews half a pound of the nicotine gum each day — the less of that fucking smoke that goes into her lungs, the more they'll be able to give her the oxygen she needs to move about, stand for an extended period . . . and survive a future operation.

Oddly enough, my dad just called on an unrelated matter, and I brought up the smoking question. He is indeed very sympathetic to the idea of Mom dropping this habit, but I want to help him be the best support he can be, seeing as he's not only on the scene to provide it most directly, but also because getting that secondhand smoke out of the house will bail his lungs out as well. He's been closely following the New Jersey smoking ban, because as the treasurer of his local Elks lodge, and incidentally one of the few members who doesn't have his head up his ass, he has been working to convince the more stubborn brethren that yes, the ban affects fraternal orders, and yes, it will be enforced. I mentioned how we should try to get her to continue on the patch if we can, so I am hopeful he'll try to ease the topic into conversation as early as tomorrow night if she comes home then.

On that topic, he believes Mom indeed will come home tomorrow. The insurance won't keep paying forever, unless the doctor perceives her condition as still weakened enough to warrant it. If she is breathing strongly without oxygen, she is likely to be given a sheaf of scripts, a bag of wound dressings, and a hefty bill. Thus is the state of the hospital–insurance complex. I feel the faster she is able to walk around her own house, sit on her own deck, and sleep in her own bed or chair, her spirits will rise and her healing will accelerate. If I need to take a day or so off to help that happen, I will. But I suspect she really wants the routine back, and my hanging on her is not gonna help. Looking at those two carotid photos, and deciding for herself how to proceed given how close a call this was, may help a lot more.

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