Friday, February 5, 2016

Madness, Escaped

I had just gotten to sleep, sometime around 8 in the morning, after a night spent plotting strategy. At nine, Lady called, telling me that she’d pick me up ten o’clock. So I had an hour to get ready. The first thing, of course, was to coax Mr. Fernández out of bed.

It has to be said: the wrong person in this couple has been ordered to do two month’s bed rest. Because Mr. Fernández would happily go into the bedroom, draw up the covers, and emerge—bearlike and grumpy—to bed feed. In fact, there is heated debate among those who know: who gets more sleep, Raf or the cats? Probably the cats, because little things like work tend to interfere….

So I was ragged, weary, and very much in pain—at which point Mr. Fernández began the, “have you seen my….” Do I remember whether it was his shoes, or his jeans? Of course not, because even if I know perfectly well that whatever-it-is is wherever-it-is, the response will be, “no I looked there, and it’s not there.” So I now simply say, “nope.” Mr. Fernández, with a voice dripping suspicion, then inquires, “then where are they?”

In fact, I was in full swing myself, since the one piece of legal identification I possess—my passport—had gone missing. OK—I knew exactly where it was: in a shirt pocket. The problem was that for two months, I hadn’t done any laundry, since the very idea of lifting a laundry hamper was completely unthinkable. Fortunately, Raf’s aunt husband had died, and his aunt had sensibly unburdened herself of her husband’s clothes by giving them to her sister, Raf’s mother. Why? Because Raf’s mother can’t bear to see things not put to use. So my mother-in-law had called one afternoon and ordered me to collect the clothes, and I had been happily going through a dead man’s wardrobe for two months now.

So the passport was in some shirt pocket or other, because I had taken it down to CVS to prove that, yes, I was Marc and they could give me Klonopin. Great—but which shirt pocket? So I was in full swivet, or perhaps a greatly magnified snit, and did it help when Mr. Fernández asked if I would make coffee?

The phone rang: Lady was downstairs. So we left, uncaffeinated, and scanned the street for Lady. It had occurred to me: going to the Emergency Room was essentially the same as going to Wisconsin, and so I looked for a suitcase. And I found one, too, but it was black, and unfortunately, the cat who had been sleeping on it for the last half a year was orange. So the effect—while somewhat reminiscent of Hallow’een—even I couldn’t bear. So we were bearing my knapsack, stuffed with all the electronics and chargers I own, pillows, a blanket, and two sweaters. In short, it looked like moving day on Fortaleza Street.

Lady—except on rare occasions—operates under the principle that she does not drive, she is driven. Therefore, I had no idea of what car or driver might be picking us up: I found Lady in the passenger seat of Jack’s car.

Lady gasped when she saw me, put her hand to her mouth, and said, “oh, no.”
I gave her a smile, and then looked out the window, since I could not bear to see the look of horror on her face. We were quiet for a while, and then Lady, to break the silence, announced that she had put the up the Christmas tree the night before, and that one of the cats had taken it down, rather less carefully, in the middle of the night. So that lead to a discussion of Christmas trees, and then later—and don’t ask me how—a discussion of the business practices of the martial arts school of a mutual friend.

‘This is what life is,’ I thought, ‘or what it used to be. Here I am, faced with the possibility of paralysis, and here Jack is, worried about an extra ten dollars that the school has lifted from his bank account.’

“I think something is licking the back of my neck,’ mused Mr. Fernández speculatively.

“Jack’s dog is right behind you.”

We were on the same bumpy road I had been down the day before, and arrived at the lab. I asked for two copies of the report, and gave one to Raf. Why? Because I wanted an extra one, since I knew that Centro Médico would keep the original.

I’m happy to announce that Centro Médico completely exceeded my expectations in one vital function: pastoral care. In fact, the very first person we saw was a volunteer, who was talking non-stop to the people waiting in line ahead of us about the power of Jesus. We heard about the miracles, we heard that he hears every prayer, that nothing is impossible for those who believe in Jesus. The relatives of the patient being seen in triage were nodding mutely, I was looking away, and thinking of unfair it is that we can close our eyes, but not our ears.

Finally, it was my turn.

“I love Jesus,” the man said to me, in English. Before I had a chance to snarl, the door opened and I went in to triage.

The first problem was that my blood pressure was sky high, but that may have for the best, since the nurse decided to order a gurney for me. So I did the admission (they fell for my voter card, thankfully), and then, there we were, in the “yellow” zone.

There was nothing yellow about it: I was lying on a gurney in hallway with 26 other people lying on gurneys, each accompanied by one and only one person. So we were to wait, and did we? Yes, but after the first two hours, waiting began to look less like an acute thing than a chronic condition. I dispatched Mr. Fernández to interview the relative of the gurney-mate across the hall.

“She’s been here since yesterday, at 7 AM,” he reported.

We went into action. I called my brother John in New York: a lawyer, he responded with logical, practical suggestions. The problem? We were in a place where logic had long since fled, and there was only torpid lunacy. So the hours dragged. I decided to call my doctor, who was distressed to learn that nothing was being done.

“Just stay there—it may take a few days, but you need the best medical care available.”

At this point, I had figured out that “yellow zone” meant that I was expendable, and forgettable. Why? Because obviously “red zone” meant cardiac arrest, massive trauma, conditions that required immediate response. But little Marc? There was nothing wrong with me, barring a sky-high blood pressure and a broken back.

The phone rang: it was a friend, a self-made man who, appalled by the political mess on the island, had decided to run for governor. So I was talking to him, or rather, Raf was talking to him, because all of a sudden, I couldn’t cope. I had had no sleep, I was in pain, and I could no longer pull the strings that would move the crowds of marionettes to give me care. I was in the hospital, and I needed help, and I could not help myself.

So Raf was talking to the candidate / friend, And I was then dealing with John, who was halfway to ordering me to be medevacked. Completely frustrated, I lost it with John.

“Look, I know I should do this, that, and the other thing—I know, I know, and you would do it and everything would be fine but I don’t have the strength and I don’t have the energy and if I try to do all that I’m just the demanding gringo and…”

…and I break down sobbing in the hallway of Centro Médico!

OK—pulled myself together. Raf comes back with the news that my friend has a friend who is a doctor in the emergency room of a local hospital. Should I go there, or should I wait for three days for a specialist?

In the meantime, the one doctor I have seen (barring the two student eye doctors) has taken the office marked “green zone.” (That’s how I figured there must be a red zone…) And about him were two curious facts: he was the oldest person I had ever seen, and he seemed to have no patients. That did not prevent him, however, from sitting at his desk, shuffling papers, and occasionally glancing at the empty chair. Was he seeing patients there? Remembering them from days past, or perhaps from the Crimean War, where he palled about with Florence Nightingale? Periodically, he would shuffle to his feet, go out into the hallway, look confused, and then return to his desk.

‘He’s a ghost doctor,’ I thought, and wondered if it was worth it to coax him back to the living. No, I decided, he’d probably try to bleed me with leeches,

All of this is interrupted by the sight of an older gentleman in a Roman collar, who is going from bed to bed, praying over the patient, and then—apparently—giving Last Rites. Was he? Well, I’ve never had them, but he was pressing oil or unguent or something on each person’s forehead. And that was enough for me—we sent him away, even more rudely than we had sent the first.

“We should have told him,” I told Raf, “that I had had Last Rites six hours ago, before I even had triage, and that really, lying on a gurney in Centro Médico offers comparatively few opportunities for sin. Although I suppose lack of charity…”

So then it’s time to call my doctor, and float the idea of a regular doctor in a regular ER, versus an imagined specialist in a lunatic ER. But first, I have dragged myself to the nurse’s station, and wheedled and pleaded for information. Nor was the situation entirely bad—I was only ninth in line to be seen by the ER doctor. The bad news? Absolutely all of the neurosurgeons were at a convention at a resort on the other side of the island.

So there I was, explaining to the doctor all of this, and telling her that it was getting late, it was a Saturday afternoon, which has the curious tendency to become Saturday night, and what happens then? Well, the island starts drinking, the boys get unruly, and they start to shoot each other. Then, they get into their cars and crash each other. So, if I wasn’t getting attention now….

“Marc,” she told me, “you need to stay there. Your back is very, very unstable. One fall, or even one sharp movement, and you could have serious and permanent damage.”

I decided to get it out in the open.

“I presume you’re talking about…”

We both said the word at the same time:


I knew this, of course. But now it was out in the open, and now it suddenly became all the more urgent to see a specialist. I decided to play the ace up my sleeve.

Remember the copy of the MRI report that I had asked for? I had figured out the strategy at 3 o’clock in the morning. Raf’s cousin is a neurosurgeon in a city some twenty miles from San Juan: could she help? The only problem is that we didn’t have her number. So then, we were calling the widow of another cousin, who was calling the husband Raf’s cousin, the neurosurgeon.

“That’s the only way to get ahold of her,” Raf reported. “You have to go through her husband…”

Finally, the husband was located, the situation explained, and the call made to the cousin / neurosurgeon. I sent Raf off to read the results of the MRI.

“She said it’s a lot worse than she thought….”

“OK—next step?”

“She’s calling people she knows at Centro Médico, and she’ll get back to us…”

She did.

“Marc, we have to get you out of there, and down to my hospital, where we can take care of you.”

She had, after all, worked at Centro Médico, before she escaped the madness of the place. And so we set off. I told the first person I saw that I was leaving AMA—against medical advice.

“You can’t do that—you have to sign some papers. Wait just a…”

“No,” I said, “I have been waiting for six hours with a dangerously high blood pressure and a broken back. A neurosurgeon has agreed to treat me in Caguas. I don’t have time to wait for a paper to sign.”

And I left!