Tuesday, January 19, 2016

Hospital Daze

“So write about the pain,” said Lady, who regards the lack of a blog post as a sort of betrayal. And does it matter that I can barely sit up? Of course not, because ever resourceful, she has the answer.

“You can just dictate into the phone, and it will record and format, and automatically upload to the blog, as well as any YouTube videos you want to include!”

I have no doubt that my cell phone can do this. But its user? The guy who couldn’t figure who the three missed calls were this morning? Yes, maybe on a good day I could do it, but not when I had a famished Hannibal Lecter salivating at the base of my spine.

But all that is beyond the point. Pain is another country, and to go beyond it, into the land of health, you first travel through the checkpoint of amnesia. And worse, you traverse the same checkpoint on entering.

Consider, for example, how I spent my days: reading, writing, playing my cello, and teaching. Was any of that worthwhile? What should I have done, that last day before all that taken from me?

I had been to the hospital and suffered through seven or eight hours of institutionalization, and had escaped it all by meeting a Puerto Marcus Welby, who instantly realized that the doctor treating me was either a quack (she wasn’t) or having a bad day (she was, but so was I). She had, in fact, come into my—well what was it? It was neither a room nor a cubicle—rather, it was a space containing four beds and four people. So she entered into what I began calling and “no man’s land” and addressed the IV bag. Like a fool, I thought I had priority, and asked whether she had seen the results of the CT scan.

I had spent two hours drinking barium, and then had promptly been taken off to get a scan of my abdomen. The very nice radiologist had told me that he would read it, and then deliver the results to the nurses’ station.

That had been three hours ago, during which I had frozen silly, since the ambient air temperature is a weird feature of all Puerto Rican hospitals. You readers up there in Wisconsin, on this January day? You ain’t felt nothin’….

So I was there, covered by—and could I make this up?—a large piece of paper, which yes, was in the shape (roughly) of a blanket, but there all the similarities ended. Oh, and since no one has invented a paper pillow, I was also getting a stiff  neck. Anyway, there were three other people in our corner of the ER, and then Raf came into the room. (He being Mr. Fernández, and also my husband, since I’ve gotten tired of writing “friend” on forms. Look, do I wash my friends’ underwear?)

So he gave me a look that I’ve seen on those horrible days at the vet, and that’s when I realized: I definitely wasn’t ready for my screen shot, Mr. DeMille. So we had chatted and held hands, and then we had agreed. The sensible thing to do was go home and feed the cats. Why hang around doing nothing? I was within spitting distance of discharge, I am a former nurse, I can play systems: didn’t I survive for seven years in corporate America?

And so he left, and oddly, seeing him go, I got tears in my eyes. He was living, you see, in that other world, where cats are important and a problem is that you forget to pick up the laundry.

So he left and I waited. And waited. And then—completely lacking in imagination, this time around—I waited some more. I waited for perhaps three hours, periodically checking to see if the doctor was in sight. Was she? Of course not. So I went back to the default mode, which of course was…waiting.

I’ve said it before: Puerto Rican doctors are excellent, but the hospitals? Well, my mother-in-law had spent three months in one of the best hospitals on the island, but what happened when she needed  an X-ray? Well, the doctor wrote the order, the nurses sent it down to radiology, and then the excuses began. Pedro (the X-ray guy) had an emergency. Then he had lunch. Then—and finally the truth finally emerged—Pedro was…well, nobody knew for sure.

The sisters were enraged. And no one can fault Mr. Fernández’s sisters for lack of energy or (especially) character—they embarked on a search for Pedro. Remember the search the Boston Bomber? That was a summer’s day picnic in comparison to the quest for Pedro. True, the sisters lacked high power weapons and helicopter support, but everything that could be done was. The sisters charged through doors marked “Authorized Personnel Only” They not only looked into dumpsters, they overturned them. They corralled staff and interrogated them, in an attempt to learn not where Pedro was, but where he lived or liked to drink. Finally, Pedro was found, and two sisters stayed with him to make the voyage to mother’s bed; the other went to bring the glad news to Mother.

Oh, and they were good enough to turn his pager back on!

I saw all of this, but did I remember it, as the hours passed in the ER? Of course not, and so I looked around, and began to get gloomy. I am still young, comparatively, but the when I get older? When being in doctor’s offices and hospital beds is less than an oddity but rather a parallel reality? How will I fare? Because it was not just I, waiting for Dr. Godot, we were all waiting for Godot. And with just the same results.

I began to think—can I grow old here? It was bad enough for my mother, up there in Wisconsin, whose only complaint of the hospital was the staff’s use of the expression, “go ahead?”

I asked about this.

“Well, everybody who enters the room says something like, ‘well, let me just go ahead and change your sheets. ‘ And it’s beginning to bug me. Why can’t they just say ‘may I change your sheets?”

Obviously, having been an editor for years, she had carried right on, and was practicing in the auditory realm. I will say, however, that after an hour’s time, it was bugging me.

The point—and my mother would have deleted that digression—is that having a problem with the use of “go ahead” is, well, not a problem. One could safely call it a quibble.

Some people—were they bribing the staff?—did manage to leave, and then, as quickly as the orderly was able to rip the paper off the gurney, other people arrived. And that was when the gods who rule over Puerto Rico intervened.

It was a gentleman who clearly wasn’t well; it was his wife who clearly was worried but also very practiced in the emergency room arts. Why, well she came with all the luggage of Edwardians embarking on a transatlantic cruise. Blankets? She had three. Pillows? Impossible to count. Oh, and the snacks? Had she held up Zabars?

(For those not familiar with Zabars, well, the cheese counter alone is as big as your average living room….)

So she was well travelled in this land, and she heard the terrible words of one who was not. That would be me, and that would be the doctor, just returned from her facial, pedicure, and deep Swedish massage—complete with heated stones from the mountains surrounding Uppsala, but I digress—she appeared, looking ten years younger. And we had not a conversation but a clash.

How did it happen? I don’t know, but I must have asked about the MRI, she must have responding brusquely, and I snapped.

“Listen, if the report doesn’t come soon, I’ll check out AMA.”

For doctors, AMA is their professional organization; for patients, AMA is “against medical advice.” A better writer could make something of this, but I am Pooh, not Owl.

And so my cellmate’s wife had heard these fatal words, as well as the doctors, hissed over her shoulder as she stomped out of the area: “Fine! Go right ahead! You’ve had excellent care!”

Here, the limitations of the written screen are glaring, because there should have been the sound of a thunderclap, or maybe French horns, or anything that the studio could rustle up to indicate an ominous sound. It was clear: I would never see that doctor again.

Yes, it was over, and so I was going to have to wait until her shift was over, and then start in on the next doctor. Here my fellow traveller stepped in, especially after seeing the radiologist, come to collect her husband and intercepted by me. What had he said?

“Oh, I left the report at the nurse’s station a couple hours ago!”

She was good enough to turn around, put a restraining hand on the radiologist, and tell me. “I’d go to the nurse’s station and gently inquire. Oh, and never go to the ER alone….”

She had reminded me: direct confrontation is impossible in Puerto Rico. What’s needed? The ay bendito, which is impossible to translate, but which you can read below.

I went to the nurses’ station and waited until someone made eye contact. This is important because, well, if they refuse to look at you, why would they help you? So an older man, looking very much like a doctor, looked up and greeted me. I returned the salute, inquired about his family, saw pictures of his latest grandchild and also some Paso Finos (he was a horse enthusiast) and then—after getting his address so I could send him a Christmas card –I started what I needed to do.

“Listen, I’m really sorry for the bother, and I know how busy you are, but I’m a little confused. You see, the radiologist told me that the MRI were at the nurses’ station, but the doctor says she hasn’t seen them. Could they have been misplaced?”

 It worked: the doctor found the lab results, read them, explained them, and told me he would discharge me at once. The ordeal was over.

I got a prescription for an antibiotic, paid the fifty-dollar deductible, and then called Raf and told him I was on my way. No problem—I would take a cab, since it was Condado, only 11:30 or so, and the place would be hopping. I mean, it’s a tourist area, and popular with the young crowd….

It wasn’t. Either the vogue changed, or the whole island was attending an AA meeting, but even the ghosts had deserted this town. So I walked the empty streets—I was hoping they were empty, because something told me that anybody I encountered on this street would make me long for the emergency room—until at last I hailed a cab. It was, thought, bad but over.

Wrong. It was starting, and about to get much worse