2008 Reflections: March: When all Else Fails, Go Limp

December 26, 2008

“There, where one burns books, one in the end burns men.” — Heinrich Heine (noted in my journal, March, 2008)

Hubris

Belligerent self-confidence is unpalatable, especially when unfounded. And it ruins your bedside manner–you!, the doctor on call in lieu of Dr. Gravitas*, my reliable (if milquetoast) GI. You were a stroke of bad luck at the end of a day that had already been a streak of poor fortune.

At this moment, when you arrived, haughty and ill-tempered, I was far too coherent. The Dilaudid had not saturated my veins and I was regrettably stupor-free. I had started noticing how dingy the beds and electronics and furnishings were in the abdominal wing, and my IV pump puh-chucked vexingly as it metabolized relief into me. There had been brief tears (Embarrassing! In front of my mother, poor thing!) and a gestalt moment when I screwed up my face and looked at the wall opposite (the names of my nurses and aides in dry-erase on a white surface; a poster urging me to ask my attending doctor if he’d washed his hands between patients) and said levelly, as if holding court: “It really hurts.” My mother, not one I would describe as a hand-patter**, patted my hand.

You now, again, entering with the flair of someone playing a doctor on TV, my chart in your left hand. I swear I remember the white tails of your lab coat flapping behind you in the breeze of your own swagger. Your name sounded like the monster in a pulpy Victorian Gothic novel. It was laughable. You have a laughable name.

This had not been a good day. The night before, David drowsed next to me when I was reading. I think the book was something about a battle or a war. Maybe about the sack of Constantinople in 1453 or maybe about the Great Plains during the Depression, which was its own kind of battle. I was drowsy, too, not paying attention in a cosmic sense, just a quiet reader in a small warm cone of incandescent light. I had a cramp. This was not unusual for me. But this felt strange inside, as if all of my intestines had stopped, stuck in fiery mid-clench†.  I felt my mouth go into a circle shape, and I said: “Oh.” Then I turned off the light and went to sleep so I wouldn’t have to pay attention to it anymore.

In the morning I staggered to my computer and punched off an apologetic email to my coworkers and then stumbled back to bed. I called my surgeon. They said a heating pad might help. When I woke up next David had already gone to Walgreen’s and bought me one. This was very kind but as an anodyne it was useless. I called my surgeon again in the early afternoon. This time the timbre was different.

“Doctor says emergency room,” the medical assistant said, though she may have used more grammar than that. “You might have an obstruction.”

Renaissance 1: The Womb-Curtain

The emergency room at St. Vincent that day was pathos in full bloom. A large, lethargic man had just swallowed an entire bottle of Vicodin. A construction worker was vomiting bile. A couple came running in carrying a motionless toddler. I lay on a gurney in the waiting room. An hour or two passed.

Something about my life changed during that feverish time on my gurney. I heard an elderly lady in handcuffs argue with a police officer whose car she’d just rammed. I was behind a curtain, alone with David, so most of the other sounds I heard remained unidentifiable, aural hints of need or aid that remained detached from their confirming visual cues. The curtain was peach-colored and there was no light on our side. So looking through it was like looking through someone’s organs, like being inside of someone. I felt sheltered, but also hot and confused. Maybe this is what it is like before you are born.

As time ticked by in my waiting-womb, the sounds and shadows beyond did not fade in their heightened intensity, nor was there less pain surrounding me. Yet I started to disconnect my psyche’s ratcheting effect, that lockstep that always tightened my own fear another notch when I sensed someone else’s. I felt looser, limper.

Maybe I was just profoundly sick, but it seemed like a transition point. This is where the unfolding of certain frightful rituals started to feel like something tolerable, familiar. An IV. Start drip. A CT scan, this time without time for the radioactive milkshakes (I picture the outcome as a shaky, blurred image like an old Dagguerotype; a primitive smear compared to the orderliness of my first CT scan). Morphine. By the time the emergency room doctor confirmed that I did have at least a partial obstruction, I was so tired of fighting the fear and the grinding physicality of it that I merely nodded and stared at the wallpaper border in my little ER-cubby. This was fine. When he said I’d need to stick around for a couple of days I didn’t change my expression.

David leaned over my bed. “You want to stay, don’t you?” He seemed tired, almost exasperated. But if it meant they’d make it hurt less and I could just rest, rest, then yes, I did want to stay. I ran that around the track of my thoughts a few times: I wanted to stay in the hospital.

As this was happening, as the blessed nurse came to believe that morphine wasn’t enough§, as I became limper and limper, the doctor was talking to me.

“They say you might have Crohn’s disease?”

“The jury is still out on that. I don’t know,” I said.

“This looks like it could be a classic Crohn’s complication.”

Herr Doktor

OK, so here you are. I’ve been wheeled up to the abdominal ward and I’m cranky and wound and exhausted and you’ve come to deliver the gastroenterological dirt.

“It’s a bowel obstruction,” you say, without considerable preface. You do not want to be in my room, talking to me. This occurs to me with such clarity that it pisses me off.

“The doctor downstairs said it could be Crohn’s?” I say, with the deferential rising tone of a question.

“It’s not Crohn’s,” you said, sneering. “It’s a textbook bowel obstruction, a complication from the surgery. He doesn’t know what he’s talking about. Nothing by mouth. You’ll be here a couple of days.”

Renaissance 2: Beyond the Ides of March

This is what March was like, from one angle. This two-day hospital stint had a an echo; I endured another night in the ER a few weeks later. There was more discord between the opinions of doctors and it wasn’t helpful.

My circadian rhythms are errant at the best of times. Now they were chaos. Often I was awake when no one else was and asleep when everyone else was awake. Various mitigating drugs fought over my processes. I curled up around myself and walled off the part of my brain that made up scary stories about horrible medical eventualities. The lack of dark fantasizing coupled with sporadic insomnia left me a lot of time to think.

I spent a lot of time in the attic, cheerfully sleepless, reading works of Classical Greek. My journal started filling up with notes about dactylic hexameter and Homeric epithets. Right below an entry in which I swear off hospitals is a scrawled genealogy of certain Titan and Olympian gods. During the day I talked to people about needles and pills and at night I read and thought about the shape of humanity. There was a vacuum left by the absence of focused panic and I began to fill it with the outlines of archetypes and consistent metaphor. I stopped taking certain literary patterns for granted. I even read Alberto Manguel’s book about The Iliad. I was willing to be that meta. “I am a broader person,” I wrote, as a result of it.

It’s not that I lived a fully binary life. I wasn’t just sickness and cerebral. There were good and very bad family shifts. Friends who appeared more often in my woes, and those who faded. David brought me soups and I tried to make him giggle. Aileen swelled with incipient life. Work was left undone as I convalesced, and the guilt of this I didn’t talk about much but suffered from. I didn’t see my mother enough. I didn’t see my grandmother enough.

But amidst the mystery of what was happening to me, I was turning inward. I was regarding ideas and myself because it was safer to do so now. Watching the snottiness of my warring doctors made me stop and think about my own negative behaviors. I questioned myself fiercely. Amongst the good seeds of new concepts I’d been sowing I was inadvertently mingling noxious weeds of self-doubt that would dog me in the months to come. Succumbing to the blissful limpness of a new kind of mental freedom was not without its risks. But I sure had a lot to think about.

* Not his real name.

** This is not to indicate any lack of warmth on Mom’s part. Her love just doesn’t usually involve that particular gesture.

† Technically, when you think about it, correct.

§ It isn’t, and I’m not alone. Not everyone has the right “receptors” for regular morphine to do the trick.

4 Comments

  1. autumn says:

    oh, dearest

    to speak with such salience and beauty about your pain…

  2. Don Park says:

    your month-by-month retelling of 2008 is fantastic writing and the struggle is easily applicable to the reader’s own situation. thank you for the story so far and i hope to read more.

  3. sandra says:

    i stumbled upon your blog through twitter, where i have been following you, unbeknownst to the incredible writer and person behind it all. i’ve spent some time perusing your most recent entries and want to thank you for sharing your experiences. i, like so many, share and can relate to your experiences, so eloquently written, with doctors, hospitals (and even flying).

    thank you, again.

  4. Gary Walter says:

    As a paramedic in Washington County, I’ve spent half my life in the STV’s Emergency Department. I picture it well and wonder what MDs and RNs you encounter, with whom I used to consort.

    This is some of the best writing I’ve encountered in ages. It reaffirms in me the line from the Serenity Prayer, which says, “Understanding that growth comes through pain.” I wish it weren’t so, but, it is.

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