Post-Op (II)

Ray of light

When I got back from the hospital, the cat was affectionate but also appraising, looking at me as if she were trying to figure out how badly I was injured, whether I would die from it or if perhaps she would be able to kill me with her new physical advantage. I’ve been back several days now and she has actually been good about it. She still demands attention and food, but not by putting her claws in me, and she also seems to understand that I can’t roughhouse with her as much as usual. It’s as if she were being careful with me.

I’m being careful myself. I have been eviscerated and I am weak. At the time of my last big surgery, more than 25 years ago, I was stronger and stood the wounding better; in fact I considered my further hospitalization a bit of a nuisance. But when they told me this time I was being discharged, I wondered whether they weren’t rushing.

The resemblance between invalidism and old age is daunting, especially when you’re actually old. If you’ve been around the track a few times, you may know how the ego struggles against acknowledging any diminution of powers, insisting that you’re only as young as you feel, so you will feel and thus be young. But when the diminution advances overnight by the equivalent of (let us be optimistic and say) ten years, it’s harder to pretend. You know eventually this is what’s it’s going to be like every day; it will take longer to stand and to sit and (especially) to haul yourself out of bed and to and from the toilet, and if you don’t have a drain (and who knows), then something else will hobble you, not because you’ve been cut, this time, but because your whole apparatus is wearing away.

So now I’m healing. I’m noting my progress metrics and changing my dressings. When I’m tired, which is nearly all the time, I rest, diddle with Twitter, read books, or just lie back and listen to the noisy central air, the birds in the pear tree, the cat tearing up a rug, my wife rinsing a dish. I am not impatient of recovery, but I will be glad when it arrives.  

Recovery gives me time for some things I usually rush past, like gratitude. I don’t wish illness on anyone — well, hardly anyone — but I do wish every citizen could get a patient’s view of what they do at the NIH Clinical Center. I’ve talked about the research, but that’ll be abstract to a lot of people; the Clinical Center is where they give direct care every year to thousands of Americans on clinical trials, many of whose own local health care opportunities (not to mention health insurance) are inadequate. Quite apart from what the whole organization does for us all in the meta sense, I think that’s fantastic. I love hearing all the different dialects and modes of dress and manner of the patients, knowing people from Roswell and Ripon and Little Rock are getting their chance, too.

The doctors are fantastic, as you’d expect, though I realize however good they are in the “patient-facing” department they do nearly all their best work when the patient is absent or knocked out. This time I mainly focused on the non-docs working hard all around me.

For three days, for example, I had a little guy steal in at about 5 a.m. to click on the light and do a small blood draw. I was never sufficiently awake to get a good look at him; he seemed to be a little over five feet tall, dark, and his voice — which I only heard saying “No, is OK” if I tried to sit up and “li’l stick” when he jabbed me — was gentle and sounded Spanish, maybe. His draws never hurt and I was always able to get back to sleep after he hit the lights and ducked out. Sometime I wonder if I dreamed him.

Contrary to late 20^th Century popular fiction, nurses are always great. Sometimes we can’t understand what they’re doing for us. When I had my first big surgery at age 12, in the days of glass transfusion bottles, morphine, and nurses in starched whites — and before laparoscopic surgery — I was practically bisected and had to be walked around the ward every day to keep the wound from healing wrong. My escort on these occasions was a no-nonsense woman who greeted me with “on your feet” and marched me around and demanded I straighten up as I moaned and panted, for which act she never fell. I thought her mean, and much preferred the night nurse with blonde hair and a soft Irish voice who fluffed my pillow and gave me a shot in my bum that put me to sleep, and who I wanted to marry. It took years for my dumb self to realize that both women had done me a crucial service.

Fortunately I have matured sufficiently since then to aim my resentment over having to do exercises at a cruel and unjust universe rather than at nurses, and perhaps in consequence mine were gentler about it. One young Ghanian nurse, mild in voice and manner, simply told me the things I should be doing repeatedly, in the same guileless and non-confrontational way, but adding “right?” at times when I had just been vague about concurring in their importance; though I can’t swear it, I think she’s the reason I haven’t already started blowing off my drain tallies.

Another nurse, older and white, took a different approach. She had been on the job a long time — something other workers on the unit told me is unusual even at NIH, due to the stress. She was externally tougher than the others, but emphasized the necessity of therapy, not by direct warnings but by telling me, in a steady voice and with a dead level gaze, about other previous and unnamed patients in similar situations whose adherence had been inadequate, at least in her view. She described telling the husband of one such patient that he should prepare himself for the grim task of telling her loved ones that she died of pneumonia exacerbated by failure to do ward walks. I like to think she picked up on my Catholic upbringing and thought I would be responsive to such an approach.

Despite my jaded roué act, I’m pretty sentimental about some things, and one of these is the elevating nature of good work done for a good cause. Everyone working at the Clinical Center, from the cafeterias to the clinical directors’ offices, is part of such work, and I swear in all my interactions there I get the sense they feel as lucky as I do to be there. It’s the same feeling I get anywhere people gather to make something good that can be shared, like theater or food or activism; it lifts and enlightens everyone in the process. Like I said before, it’s a drag to be sick, but it’s great to have them on my side, and to be on theirs.