Thursday, January 7, 2016

The Song of a Sickness, Part One

When it started I cannot tell you; nor can I tell you when—or even if—it will end.

Right—“it” may not be the word, unless you mean a three-month period of torrential pain, hospitalizations, emergency room visits, and terror. But perhaps “they” is the better word, since the whole ordeal began with stomach virus.

“Eat,” adjured Mr. Fernández, my husband, “you have to eat!”

It had become well past annoying. I had lost any appetite for fried—however lightly—food: the smell of it was nauseating. And much of the meat we eat is lightly sautéed in whatever the healthy oil of the month is. So mealtimes became agonizing: I would pick at my food, arrange wine bottles strategically in front of my plate, invent excuses of eating late lunches.

The loss of appetite was the one mentionable symptom of the virus, which I must have had for years. In fact, in those years of working at the home office of Walmart, I had assumed that I—like every other middle manager—had irritable bowel syndrome. It was almost a badge of honor—like working until they closed the building, or sending emails from home at 3 AM. After the weekly bloodbath on Friday morning—that was when the complete team would assemble—there would be a stampede for the bathrooms, and it was always the stalls, never the urinals, that were needed.

So my stomach was bad, and my guts were contorted but guess what? That was the price you paid. But why, six months ago, did everything get worse?

It’s one of the mysteries of the virus, Helicobacter pylori, which apparently lives contentedly in the guts for years, before it gets uppity, goes on a rampage, and decides to kill its host. And so for months I suffered every indignity the gastric system could devise, until one Monday I could bear it no longer: I called my doctor. When she heard about the various eruptions from all orifices, she told me what any sensible practitioner would: go to the emergency room.

Going to the emergency room is a code term for submitting yourself into a different world—one in which your neither know the landscape nor the language. Though in fact I did, since I had worked for ten years as a nurse. That, however, had been in serene Wisconsin, and then later in more dicey Chicago. But in Puerto Rico? How would I fare here?

I arrived at noon, I sat for an hour in the waiting room, until I was called into triage: this in itself was a bit alarming. Granted, I wasn’t spewing blood all over the furniture, but how did they know I was having a heart attack? Were they that good, that they could diagnose at mere glance?

Finally I was called, and learned two things: by blood pressure was seriously low—90 over 60—and my weight had dropped fifteen pounds in the last two months. So then it was time to sit for another hour in the hallway of the emergency room itself—all the better so that I could imagine from the groans, and sighs of the patients lucky enough to have beds what was happening behind their curtains. My companion in all of this was a woman suffering what must have been pneumonia. I had once either read or imagined that the velocity of a sneeze is around ninety miles an hour: my companion’s cough was easily twice that. So it was clear: however effective the cure for my guts might be, I’d still end up here in two weeks time, for a malady one system north. The Walmart manager in me began to admire the business model: the emergency room was clearly curing one disease even as it was incubating the next one. And so after I was afflicted with and then cured of the pneumonia, what would the next malady be? Strep throat? Migraine? And would it always travel upward? If not, were ingrown toenails contagious?

Worse, I began to see what the daily rag had been saying all these many months, since virtually everybody was over 80: I, in my late fifties, was at last once again the spring chicken. So there was no lack of patients—indeed, it was the Christmas story of no room at the inn—but where were the doctors? Easy—three thousand miles northwest in the states, where they can make a decent living.

Here, it’s time to say that Puerto Rican doctors are—in general—much better than their gringo counterparts. Why? I’ve no idea, but they are both better prepared academically and spend more time more caringly than other doctors. That said, the doctor who admitted me was the complete exception.

We started off well enough: I told her my symptoms, she asked the right questions, and then prodded the four quadrants of my abdomen. Since I didn’t scream and hit the ceiling, we both knew it wasn’t appendicitis. So that left the other diagnosis: the rioting virus that would put me on the path to peritonitis, which, untreated, would lead me straight to the undertaker.

“Can we do this on an outpatient basis?” I asked, and it was here that the relationship began to plummet. She outlined how precarious my health was, suggested that I might not even make it to the pharmacy before the grim reaper scythed me in my path, and then pointed at me, and told the chilling words: “I own you.”

It was clear: she had major control issues. But by then it was two or three in the afternoon, I had wasted the day, and why not get it over with, if I could? I found myself—at last—on a bed. The blood was drawn, the IV inserted, and then the drugs were given. All of this was done with the least interaction possible. It was clear: I was less a person than a collection of disorderly veins and guts. So I found out for myself what medicines were dripping into me, and remembered them from nursing days long past: Cipro and Flagyl. In fact, they were utterly the right medicines to give me.

They also proved nearly fatal….