[A somewhat delayed continuation of my tales of being in hospital; third of perhaps four or five parts. Hey, it amuses me.]
[March 24 – 27, 2008]
Terrible days (Monday/Tuesday)
It’s hard to explain the slightly crazed, exhausted misery of the two days, nearly three, after I was taken out of intensive care. There is, as it happens, a solid explanation – in fact there are two of them: the morphine ceased, and all the artificial well-being gained from it vanished; but, more importantly, and in direct contradiction to what all the nurses repeatedly told me, the side effects of another medication drove me mad.
That medication was simple enough – I don’t know exactly what it was, but a shot every four hours was meant to restart my digestive system, which had evidently been stopped dead in surgery. I’m assuming it was some kind of stimulant – something close to adrenaline? – in any case, although it was aimed at the muscles of my abdomen, it affected everything, my other muscles, my breathing, and worst of all my brain.
I became frantic, wound up, wired, obsessed though exhausted: especially for the two or three hours right after the shot, I would pant, my heart racing, and pluck at the sheets in vague and unfocused irritability. I couldn’t get up of course, or really do anything at all, so – well, you can imagine the craziness of the whole thing: like being in a tiger cage that didn’t exist, or one that was made completely out of my mind and muscles. I kept thinking about brainwashing, about hysteria, about torture, about simply going out of my mind: especially at night, at times, I burst into tears from not being able to relax, to stop this strange and endless buzzing.
The nurses said that the shots had no side effects, and that therefore I couldn’t be experiencing them. I wondered – was it really just me coming down from the morphine? But the experience was definitely worse right after each shot. Perhaps I was so weakened that I felt side effects that a healthy person wouldn’t notice….
Rather weirdly, two musical experiences made these days even more disturbingly charged. When I had opened my computer in the intensive care unit, I played some music for an hour or two on iTunes – and thought that my folk tracks would be the most relaxing, the most comforting. At the time, some of them were: but for some reason one of the last pieces I heard, a reel played by one of my colleagues at the university, which had three chords that went round and round and round in a rather frenetic way, got stuck in some part of my brain.
And so, a day or so later, with this strange medicine driving me nuts, those three chords showed up again: and no other music or other thoughts were clear, nothing else much happened inside my head – not for hours – just these three simple, shrill accordion chords, round and round and round and round and….
Madness.
On the second night, in an effort to derail my frantic mind from these chords, and from other Ohrwürme that struck me from hour to hour, I turned on the radio in my room. These weren’t general broadcast radio, but a hospital radio system with supposedly about twenty stations (I never got more than five or six); most of the time it focused on rather pompous talk radio in German, which of course didn’t interest me at all. After a few unfocused hours of occasionally turning on the radio and turning it off in exasperated boredom, at about 9 pm or so I noticed a woman’s voice announcing, veneration in her tone, Wagner’s Das Rheingold, conducted by Herbert von Karajan. Well, although I doubt I could have stood Die Walküre or Siegfried (neither of which I like, despite Walküre's popularity) in my frantic state of mind, Rheingold or maybe Götterdämmerung might have been just barely possible.
So I left it on… for perhaps an hour, perhaps two. (By the time I turned it off we were somewhere in scene 3, I think.) I’ve always loved Rheingold –the gimmicky, weird bits most of all (the spacey opening, the anvils, the dwarves and dragons, the Leitmotiven underlining every twist in the panicky arguments that make up such a lot of scene 2) – so this was potentially a pleasure. However, the performance itself was a bit frantic, a bit breathless and fragmented: or was that just me and my medicines? Joyce later said she thought the early Karajan recordings were probably like that, though – a bit too energetic and assertive for their own good. And, of course, as my favorite set pieces gave way to extended recitatives, or the tiresome arguments among the gods, my exhausted mind started battling with the whole….
In any case, it was a strange and short-term relief: for some parts of that hour or two, my mind had something to latch on to. I frankly hope that I never have to hear the Karajan versions again; but I’m grateful to Wagner for a little (strange, uncomfortable) relief – or at least some change of mental scenery – in the midst of all the torture.
Joyce
Through all of this, Joyce kept visiting, almost daily (I think she only missed one or two days of the thirteen that I was in hospital). She brought tea, books, and even downloaded some of her favorite podcasts onto a flash drive in the hope that I would enjoy something and relax. In the time of morphine, we chatted pleasantly, and she expressed surprise that I was in such a good mood. In the more frantic days, at first I was just quiet and uncommunicative; but at last I started to erupt in fretful complaints and demands, like a feverish child. I tried to explain that I was feeling very strange and unhappy from the medications, that it was hard to focus, hard to chat, hard to relax; at first she treated it lightly, assuming that I was still in control, but after a few minutes she realized that I really was not quite myself.
I kept complaining about the things she’d brought, that I’d never use, that the nurses kept moving around, that I felt responsible for; about my coat and suitcases, which were still left behind in another room on another floor; about the bits of things around the room that I couldn’t find, couldn’t reach, the earplugs, the slippers. I know I was a bit crazed and exasperating, especially after trying to be so urbane for the previous days; she began to accede to demands, which were contrary to anybody’s expectations – take home these books, take home the podcasts, I won’t enjoy them, I can’t keep watching to see that they go with me when I get moved.
All of this was about control, about certainty: just as I get fretful at home when things are out of place, so in this hospital room where my own things seemed scattered everywhere, hidden in drawers that might get used by another patient if one should be brought in (and even in different wings of the hospital), I was becoming frantic at the dissolution of systems, of control. Bless her, she went up and down stairs looking for my coat, dragged my suitcase downstairs, and took many things she had brought in back home. All to keep me from bursting into ridiculous tears….
A day or two later, when they no longer gave me shots and I was calm again, we could talk in a more civilized manner. She looked at me, appraisingly: you know, you were really wound up the last couple of days….
Plateau (Wednesday)
On the Wednesday following surgery, as I became more normal, and accustomed to my room, surroundings, nurses, and increasingly part of the hospital’s schedule (and, of course, as the entire hospital itself straggled back to its usual patterns after the long Easter weekend), I started to notice more of what was going on around me.
An annoying visit from a young and clueless administrative functionary about my health insurance – I told her it was taken care of by travel insurance, by Joyce, by two young doctors who had written down information over the weekend, and that I had no names, telephone numbers, or information; she knew nothing, and seemed to have no idea how to find out anything – developed into a more substantial visit the next day from an older woman, with the clueless youngster in tow. Fortunately, the experienced woman understood what to do, asked a few more questions, said it was all perfectly satisfactory, and went and handled everything; I started to appreciate what Joyce had said, that my travel insurance seemed really excellent. Even proactive, weirdly enough: she said that they called her.
Drips, tubes, catheters: only three remaining (the drip with saline and periodic pain medications and three different bottles of antibiotics in my arm, a tube to extract unused gall (bile?) going through my nose down to my stomach, and one well, you know where), but the hard part is disentangling them. As my digestion restarts, I need to get to the bathroom occasionally, then with more frequency; but turning my body over to pull myself up, to roll out of the bed, inevitably leaves the gall bag tangled with the urine bag, and/or both around the pole where the drip is. No amount of planning and bag-arranging seems to stop this….
And mild arguments about just where to inject the drip: during surgery, while I was anesthetized and couldn’t ask them to use my left hand (so my right hand would be free for meals, computer, and going to the bathroom), they put it in the back of my right hand; then two days later, when that spot was swollen and useless, moved it to my left hand; then another spot on the top of the left thumb, then back to the right forearm… five places over ten days, leaving my hands bruised and scabbed, echoing the growing number of bruises and black spots on my inner elbows, and scattered across my thighs from other shots against blood clots, and shots I didn’t even understand.
Parts of me have thus come to look like battlegrounds, battered and ruined, a range of dark bruise colors, none of them healing quickly. But worst of all are the backs of my hands: it’s not only the bruises and scabs, but they look so dry, wasted, ancient – of course, in Los Angeles, where plastic surgery is a cultural norm, they say: you can always tell from the backs of the hands. And mine look very old indeed: I know that in some ways I am younger than my age (one nurse is startled to hear that I’m fifty-one, and says she would have said ten years younger – but perhaps she’s comparing me with all the many patients in their seventies?), and also that in the past few years I’ve tended to think myself into being mentally older than my age (depression, lack of sex, loneliness). Now the backs of my hands are an accusation and a sign, emphasizing the sense that my different ages are fragmented across different parts of my body and mind, some younger and some older; and some frighteningly, pathetically aged.
(Hands... an interesting if rather intimate aspect comes to light: as I have needles in one hand or another, plus two other bags attached to me, and am starting to have diarrhea as my digestion starts to work again, the elaborate fuss over wiping myself gets a remarkable amount of attention. Right hand, left hand, easy or difficult, coordinated versus un-: I start thinking also of the intricacies of those cultures that define the left hand as the hand that wipes, and therefore never picks up food, or shakes hands, or does anything else. I asked Joyce at one point, as her husband is Turkish, whether this seemed to matter to him or to his relatives: but she said no, that modern Turks, who have all the toilet paper they need, don't worry so much about such things. I suspect that, on my visit to Bali in the late 1990s, I was entirely unaware of this distinction – and probably offended many of my hosts, especially at the big cremation festival, around the vast banquet table of rich and alien foods.)
After a few days, I notice something else that seems peculiar: several of my fingers, on the inside, have blisters, each getting harder. I can’t imagine where they might have come from, given that I’m barely moving and doing no kind of work, and of course lifting nothing at all. Finally, I see it, looking up at the triangular bar above me, the one I use to hoist myself into and out of bed – since my muscular center of gravity, the connection between legs and torso, is absolutely out of commission, and I can’t shift my body as a unit, but only in parts and with help: they are blisters from grabbing the bar and lifting my body up, every time I move.
Herr Silva (Thursday)
Something I’ve been obliquely dreading: after I have been alone in this room for three days, very late one night, at about three a.m., the nurses bring in another patient. Ah well, I knew this peace and quiet wasn’t going to last.
Herr Silva (not quite his name, but the name that most of the nurses have settled on for him, after transposing and subtracting some letters) is evidently a charming little man, like somebody’s grandfather. He is a tiny, elderly Brasilian who has spent years in Germany; he has a face like a dark dried apple, and has had fairly major surgery of some kind on his chest. He can’t say much, but at first seems pleasant, if groggy; I introduce myself, as though I am the host of this room. He explains to the young doctor’s questions that his family is scattered across the world, there is a brother in Saarbrücken but it’s no use to call him (which is odd, because Saarbrücken is a small city only about an hour away – perhaps they are seriously estranged).
The nurses, after fussing a bit, leave him alone, and it is just the two of us. After a while, he becomes agitated, apparently uncomfortable: he is in pain, and calls out to the nurses. I ring for him, they come and ask what’s the matter, and make sure his pain medication is running; after this happens twice, there is some discussion, the dark orderly from intensive care talks to them, plus a young doctor on call; and finally they wheel him back to intensive care. I am relieved at my restored peace, though I now know that at any time I could get a roommate of any kind: which makes me a bit, selfishly, uneasy….
The next afternoon, as I pick at my lunch (which, given my condition, consists of two pieces of white bread with jam and honey), Herr Silva is wheeled in again, nurses reorganize and fuss, move things around, and generally get him settled. At least as much as he can be settled: he seems even less conscious; and, after a while, he starts to moan, periodically, in pain. I don’t know quite what to do, if anything: asking him if I can ring for the nurses elicits no response – he seems too drugged, too out of it, to know what he wants.
After the moans have gone on for a while with some breathless pauses, he starts to mumble, repeating the same word: stab, stab – why is he saying that, in English? – or is it: ich starb? –
As he moans and talks more and more, getting gradually louder over half an hour or so, I finally understand: ich sterbe – I’m dying. He says this over and over, interspersed with more moaning. The nurses come in to check on him several times, and try to manage him, give him more pain medication, do what they can to calm him down. None of which, however, works well: they are giving him simple, rational instructions that appeal to his self-restraint, which might work well in a Lutheran context; but he is, of course, in a grandly operatic, Catholic, more highly colored fashion, projecting a world of torture, tragedy, misery. Although, by their medical standards, he is not in bad shape – and, of course, as nurses they can probably afford to have only so much empathy for pain, and not much at all for fear or despair – their feeble attempts to control the situation, to tame him and his cries, go nowhere.
After they have come in several times, then left, his moaned monologue gradually extends to phrases that sound like apocrypha extracted from some lost version of Woyzeck: ich sterbe, sterbe… wo ist das Messer [where is the knife?]….
Tragic, and a bit hard to listen to, even for me. I’m mostly uncomfortable rather than disturbed, however, and I try to help, talking to him and adjusting things for him; at this point I can get out of bed without too much trouble. He starts to pull at his drip, at his tubes (an impulse I can understand, as I’ve been resisting doing that myself); while moaning on about dying and knives, he pulls the drip pole over on himself. I move surprisingly quickly, finding myself at his side, preventing him from pulling on tubes, holding the tilting pole at an awkward angle, telling him again to calm down, pushing the button repeatedly for the nurse.
One nurse comes in, then another and a third, they cluck over the dramatic scene (we are like some baroque painting, arranged in a triangle – the horizontal body, the other leaning over, holding the pole at acute angle); they thank me for helping and hustle me back to bed: this has clearly caught their attention (finally), and one of them goes and gets the Chefarzt as the other two try to talk him down.
And now there is an entire grand operatic scena for the ensemble, two or three nurses, two young doctors, and the Chefarzt talking to Silva, discussing his case, telling him to calm down, trying to figure out what to do; the nurses point out that the Herr Professor (that is me, in case you have forgotten) helped out, pointing at me proudly as though I’m a child who has done something unusually mature that may be praised but shouldn't be overly encouraged… at which point the Chefarzt looks up and says, So why on earth is there another patient in this room?
I think: hmm, that’s kind of how I feel about all this.
The Chefarzt asks the nurses, are the other rooms on this hall full? They look at each other, uncomfortable, and one starts to explain: well, E 12 and E 14 are empty, and… But he is not interested in the details, and lays down the law: Silva should be alone in a room until he is less difficult to manage, and of course until he stops moaning, crying out, disturbing other patients.
The nurses move me rather than him, as I seem more manageable at this point. I am taken to the room where I will spend the next week, and in fact where I will be until I leave: a quiet room three doors down from Silva (whom I will hear moaning, crying out, at night, for several more nights, ringing down the hallways; and I am glad I’m not right next door to him). A room designed like the other, though its mirror image, and with an unused, even slightly abandoned, feel: there will be sunlight in the mornings across my bed.
And there will be no more roommates, for the rest of my time here: the Chefarzt has spoken. Although I haven’t paid for a single, once again, prestige and favoritism rule. And I am grateful for that….
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