Assembly line hospital

Sacred Heart was like an assembly line in which patients were passed off as quickly as possible between admissions, short stay, pre-op, post-op, o.r., and back to short stay. I was seldom asked if I needed anything; and clerks, nurses, aides, stretcher pushers, doctors, and sundry technicians appeared above my face in surprising numbers only to disappear as abruptly as they came. Being flat on my back much of the time, I was frustrated by my inability to know what was going on or even who was in the room.

During surgery, two people who I couldn’t see stood in a corner disparaging conservative politicians before saying goodbye to still other unknowns. My surgeon was unrecognizable behind mask, cap, and glasses, and, since he didn’t speak to me, I didn’t know he was present until he began the procedure. The anesthesiologist stuck the deadener in my back, but never asked how I was, and I couldn’t even tell that he was in the room. The operating staff began discussing their next patient while I was still on the table. Such impersonal treatment angered Peggy who is accustomed to attending to one or two patients for an entire shift, and, if they are still there, attending to them again the next day. The best I could offer was that some of the staff had seemed more constrained by time than compassion.

I thought it a very great thing to be able to see—live and in color—the bones and ligaments within my body. No one had such an opportunity until a decade or so ago, and very few have taken it since. I also found it unsettling to look at structures that appeared so very fragile, and that served as vivid reminders of my degeneration and mortality. The glistening curves of my bone ends looked no different than those of a freshly slaughtered hog, and the bright surgical light bounced off the back of my knee cap like sunlight off the moon.

Despite the impersonality of the hospital, I remain very glad that I have access to modern medicine with all its drugs and gadgetry. The accounts I read of Himalayan expeditions often describe the extreme poverty of places where doctors are rare and their ministrations primitive. I’ve read of porters who had no economic choice but to work despite leg fractures. No matter how tightly bound, the bone ends stabbed into their flesh with every step, and, if not for their many dependents, their best hope would have been that infection took them quickly. These are the kinds of places where children still die from vitamin deficiencies. Yet, even in this country, we can but prolong the inevitable, which means that a Nepalese porter who dies from a broken leg might suffer less than an American who is kept alive as long as possible by every means possible.

I am still relatively new to age-related degeneration, and I have yet to understand how people bear it. When your joints, teeth, ears, eyes, and taste buds, are failing rapidly, and you know that a significant portion of your remaining years will be spent in doctor’s offices, hospitals, and nursing homes; how do you find a point to it all? I went to the hospital to have my knee fixed, but came home with the knowledge that its failure has only been postponed for a brief time unless I am willing to give up much that I love. I can try to measure the worth of my life in terms of how much I can still do rather than it terms of what I cannot, but for now I am overwhelmed by the latter.

I got through yesterday partly by quoting poetry to myself. One poem goes, in part:

My mind to me a kingdom is,
Such present joys therein I find
That it excels all other bliss
That earth affords or grows by kind…

I laugh not at another’s loss;
I grudge not at another’s gain;
No worldly waves my mind can toss;
My state at one doth still remain;
I fear no foe, I fawn no friend;
I loathe not life, nor dread my end

Some weigh their pleasure by their lust,
Their wisdom by their rage of will;
Their treasure is their only trust;
A cloakéd craft their store of skill:
But all the treasure that I find
Is to maintain a quiet mind.
Sir Edward Dyer

I really must find a way to remain at peace in the face of the inevitable.

Surgery day

I only slept a few hours last night before drinking a half-gallon of water and a mug of coffee before my NPO deadline. I am less nervous today. I am cheered that the sun is breaking through the low clouds; I am enjoying a few final sips of coffee; and I am happily anticipating stopping off at the library on my walk to the hospital. I’ve been reading one mountain climbing epic a week along with books on knots and orienteering. These are old interests that I return to at least once a year.

For all my love of knots and wilderness navigation, I do little of either. I often use a map and compass to identify one mountain from the summit of another mountain, but I seldom have to rely on them to find my way. I fantasy doing so, but would have to go without Peggy as she would object to the undergrowth and fallen logs. This means that I am not likely to go at all since the pleasure I find in going to the woods comes more from her companionship than from the woods itself.

I never climb any of the high mountains that I read about either, which strikes even me as odd since I don’t just read about climbs, I also read about climbing equipment and techniques. Am I not tempted then to give technical climbing a go? Not really. I get enough thrills from reading about other people’s thrills.

People who seek danger are of a different breed than I. It takes more to physiologically stimulate them, and I resent the fact that many of them glorify their need for danger as a hallmark of superiority. I must confess, however, that I am no better. I might admire the guts and determination that it takes to climb an 8,000-meter peak, but I also feel superior to those who need to do it. I don’t use the word need lightly, because people who are obsessed with danger are very much like people who are obsessed with liquor.

True, Peggy has climbed, but driving three hours to Mt. Hood and coming home the next day is worlds apart from traveling halfway around the globe and spending months on K2. These are people who evolution failed, and they in turn fail everyone who tries to be intimate with them, most tragically their children.

Time to shower and walk to the hospital. Check-in is at 11:00; surgery at 1:00.

Later

I had a spinal anesthetic without additional sedation so I could remain alert. My arms were positioned straight out from my body, Jesus style; and my legs tingled, although I couldn’t tell what was being done to them. I looked up at one point and was surprised to see my left leg being held two feet off the table while it was scrubbed with Betadine.

I was cold no matter how many blankets they piled upon me, and the surgeon joked that I would be charged for the extras. His description of what I was seeing on the color TV was very different from what I expected. Since cartilage is a membrane, I assumed that torn cartilage would appear as sheet-like fragments. Instead, it looked thin and feathery as it undulated slowly in the five quarts of fluid that were pumped through my knee. There was also a lot of it. The surgeon attacked it with a conical-headed device with revolving blades that chewed it up and suctioned it away.

I was pleased and entertained by the process until he said that I have stage three to four arthritis (four being the worst). I wasn’t prepared for this, and became nauseated when he suggested that I avoid long hikes and working on my knees. He pointed out jagged bone spurs that protruded ridge-like above the cartilage as well as spots where the cartilage was completely missing. The latter areas looked like the inner bark of a tree that had been ineptly blazed with an axe.

I was taken from surgery to post-op where I had to stay until I could wiggle my toes. I was the only alert patient there, so I lay listening to the others puke, groan, and talk incoherently. I tried so hard to move my toes that I trembled from the effort, but the anesthetic was tenacious. My fingers had long since become so cold that they could no longer be used to determine my oxygen saturation levels, and I placed them against my thighs to warm them.

My legs felt like lifeless lumps of hot fat that disconnected from my body. I touched something that felt like a rolled-up washcloth, and I speculated that it might be leftover from surgery. I soon realized that it was my penis. I glanced about to see if anyone had caught me playing with myself. As I moved my hands upward, I realized that everything below my navel was asleep.

Rat poisons and taciturn surgeons

While I was admiring the neighbors’ new motorcycle today, Baxter ate a box of rat poison that he found in their garage. I caught him in the act, and poured hydrogen peroxide down his throat until he vomited. When Peggy came home from her weekend in the mountains a short time later, she told me of a dream she had the night before in which she mounted a grill on Baxter’s head so he couldn’t eat anything harmful.

I dread surgery tomorrow. It is not major surgery, and I have never dreaded surgery before, but I dread it now. I don’t believe that my dread is a premonition. It’s just that I am not a person who can sit still, and I will be sitting a lot this week—the first week in months for which pretty weather is predicted.

Then too, I don’t like my surgeon. I have seen him off and on for a decade about one thing or another, but he has never operated on me, and I have never needed so much—or gotten so little—open communication from him. When I went for my pre-op, he quickly grew impatient with my questions, so when he left the room to take a phone call, Peggy got the answers by reading my chart. I can but hope he is a better surgeon than he is a communicator.

Any work is better than no work at all

I’m trying to tie up loose ends before my operation next week. Yesterday, I spent four hours installing a recessed light in the laundry room and still didn’t finish because:

1) Most of the work must be done from the attic, and there is so little clearance that I can barely squeeze into the space.

2) The part of the ceiling I needed to reach from the attic was beneath a sheet of plywood which was screwed to the joists, and over which eighteen electric cables were stapled.

3) Both of the cables that serviced the old light were too short to reach the wiring box on the new light, so I replaced one back to the main breaker box, and re-routed the other.

4) The new light will not completely fill the hole left by the old light, so I will have to patch it with sheetrock compound.

5) When I got everything else done, I discovered that the canister for the new light was too tall to fit beneath the plywood, so I had to return to the store and replace it with a shorter one that costs three times as much.

I reflected as I worked that even frustrating work is better than no work. I can look back at such a day, learn from it, congratulate myself on what I did right, and be thankful that I have the knowledge and the physical ability to do the job. I can also respect the fact that I never make an ass of myself by cursing God and throwing things the way my father did. I would rate me as an overall good workman. It’s not things that I screw-up and lose patience with, it’s people.

Hard time

I worked flooring the attic today. My left elbow never healed from a fall in 2003, and has increasingly come to limit how much I can crawl. I asked the orthopedist who is to operate on my knee if he could fix the elbow too. He said he could remove the injured bursa, but didn’t seem to want to, and gave me a foam support pad. I had already been using a pad that I made from a knee brace and a sponge, and his pad proved just as inadequate.

I have some carpentry, painting, roofing, and landscaping projects to do, but am holding off until better weather. For now, I’m catching up on paperwork, and the lack of exercise is getting me down. I take walks with the dogs when the rain lets up, but the best I can say for walking around town is that it’s better than not walking at all.

More flooding is predicted, and I am wondering what I will look like when I finally explode from the tedium of being mostly housebound. I’ve read of prisoners being isolated in a small cell for 23 hours a day only to be allowed to pace back and forth across a small enclosed yard the other hour, and I’ve wondered how they can face the rest of their lives with no hope for better days. At least, I know that summer will come, and that I can move to a drier climate else when I can’t bear the rains any longer.

There were several arrests here last week of so-called eco-terrorists (eco-vandals is more like it). All are in their early twenties—some of them women—and all are facing 42-plus years in prison. I think about what it must be like for someone who loves the outdoors to be looking at being locked up in a cage for twice as long as they have lived. Judges often sentence idealists to far longer prison terms than they do murderers and rapists, it being a graver matter to threaten the government or a corporation than to assault ordinary citizens.