Another day, another surgery

I was in surgery at this time yesterday, and was still on my way home fifteen minutes ago. Peggy is unloading, but I’ve already learned that the doctor wasn’t kidding when he told me not to bend over or lift anything. Here I sit spacey from Vicodin, drowsy from having been too happy and excited to sleep, and wary of even walking across the room quickly—I am dripping blood even now. The words on the screen look to be floating at an indeterminate distance, and I feel as if I last sat at this keyboard in another lifetime.

We drove to Portland a day early so Peggy could shop at the Button Emporium and visit a friend. I awakened that morning with a sore throat, and passed the day in fear that I might be getting sick. I spent most of my time sitting in the van, too sick to want to do anything else even if there had been anything else I wanted to do, and too worried to stay in the motel while Peggy went downtown alone with only her fear of city driving and her insecurity about reading maps to keep her company. I felt too bad even to read Marcus Aurelius’ essays about not letting the things of the world—including my own feelings—get me down. All I could think about was how miserable I felt, and that something—like a cold—might cause me to miss surgery.

I debated whether to tell the doctor if I did have a cold. On the one hand, I wanted to be open, but on the other, I speculated that our litigious society might cause him to err on the safe side and cancel the operation. That night at the motel, I was cold while Peggy was warm. “I’m having chills,” I thought. “Chills mean fever; fever and a sore throat means strep.” I looked in my mouth, but saw no pustules or redness. “No matter, I can’t feel this way and not have a fever,” I told myself; “and I can’t elect not to inform the doctor about a fever.”

My head and ears had ached all day, but since they ache all day every day, I was only surprised by the severity of the pain. I had already filled my prescription for Vicodin, and I took one. It made no discernible difference, but midnight passed, and I was supposed to be NPO.

I lay awake much of the night, scared sick that I might miss my surgery, and feeling blood pummel its way through the arteries in my ears and temples. I thought I saw flashing lights through my closed eyes (signs of a migraine or a cluster headache), but couldn’t be sure. I was sure that neither could hurt any worse than the one I had. My throat looked and felt no worse the next morning; the glands in my neck weren’t swollen; and Peggy assured me that I was too old to have strep. I still thought I had a fever.

When Peggy tried to crank the van, the starter made a pitiful little noise that indicated a dead battery. When I looked under the hood, the siren went off. We knew that the previous owner had an alarm system, but even after eight years of owing the van, we didn’t know that part of it was still there. I couldn’t find the siren, so I left Peggy to save herself and the dogs to freak-out in the van, while I went to the motel office. The motel had no courtesy car, but the manager offered to jump me off or else drive me to the hospital. By the time we got back to the van, the siren had stopped.

As I starting connecting the jumper cables, it started up again. I determined to find it and rip it out bodily if I had to. I finally felt it deep under the hood, alongside a wire that seemed to connect it. I couldn’t be sure of the wire, so I decided to yank the whole damn siren out to verify which wire needed to be pulled. I broke it loose, but couldn’t get it out. Being almost certain that I had the right wire, I pulled on it and quiet ensued. Peggy, mistakenly thinking that the jumper was already connected, turned the key and the van cranked immediately.

“Resistentialism: the belief that inanimate objects purposely thwart you.”
Snow’s Dictionary

The nurse in Day Surgery hooked me up to her all-in-one pulse, blood pressure, oxygen saturation, and temperature unit; and I waited in fear to see how high my fever was. It seemed like the thermometer was taking forever, and the nurse must have thought so too, because she declared it broken and went for a replacement. This one worked instantly, and the number 36.1 C. (or maybe it was 31.6 C.) appeared. I had no idea how high that was, but Peggy said it was a little below normal. My insides leaped with joy, because I knew that the last hurdle was past. As the nurse started my IV, I told her that Peggy was also a nurse and was really good with IVs. She responded by pushing the needle right through a vein—that she had just said she could hit in the dark—and into the bone. I said not to worry, that the pain took my mind off my headache.

The nurse finally left, and Peggy told me one last time that she really didn’t think I should stay awake for the surgery. I looked at her as at one who didn’t know what she was talking about.

The anesthesiologist came in, introduced himself, and said, “Open wide for me now.” “Uh-oh,” I thought. “You can close,” he said in a voice indicating normality. We talked. I told him that I wanted to stay awake during surgery. “Why?” he asked in a disapproving tone. “None of your business if you use that tone,” I thought, but I said, “I don’t like being intubated.” Well, with this kind of surgery, if we have to put you to sleep after it has started, the surgeon will have to stop the procedure while I get you intubated.” I thought it very unlikely that I would have to be put to sleep, and I knew that he knew this, but that he wanted to make things easy on himself by doing them the way he always did.

I was wondering how much trouble he was going to give me when Peggy stepped up to the stretcher and said, “Snow usually does pretty good with this kind of thing.” I was grateful—surprised but grateful. The anesthesiologist gave in: “Alright. People who ask to stay awake usually do okay with it.”

He left and the surgeon, Peter Hwang, arrived. If I hadn’t already known he was coming to a hospital that he rarely works in, I would have figured it out because no one knew how to pronounce his name. He looked a little uncomfortable as he stepped inside my curtained room, like he was worried about invading my space, and this seemed to validate my observation that he is shy. He quickly stepped into his role as a gentle and confident physician, and I had the thought that he is also strong.

When the nurse came to roll me into surgery, I was already high on Demerol, and I enjoyed watching the ceiling tiles undulate as we moved. I’ve yet to be rolled anywhere in a hospital that the stretcher didn’t clank into something, but this trip went better than most—a few bumps but no BANGS. Another nurse was already in the OR, and the first nurse told me to tell the second nurse what I was there for. I counted five people who I had already told this, but I knew it was for a good reason. Peter congratulated me on getting everything right, and I said something about him not chopping off my leg. “Or making you into a woman,” the anesthesiologist joked. “That’s a good one—I wish Peter or I had thought of it,” I told myself.

I don’t remember when the surgery began. I was awake, it’s true, but my IQ had been reduced by 50% and my mental age by 50 years. I knew that my nose was being worked on, but I neither saw nor wondered what tools were used, or whether Peter was looking through a scope or at a TV screen. I also lacked any conception of time, and only realized when I saw a clock on the way out that the operation had taken two hours. I mostly kept my eyes closed during the surgery because of the lights, so I didn’t even know where three of the four people stood. Peter was to my right, and I thought I saw the anesthesiologist off to my left instead of behind me as I expected. I also remember announcing that I had to pee, and a nurse bringing me a urinal from my left side. Peter asked me twice if I was finished before I even started, and I braced myself to hang onto the urinal until I was done.

I remember that I resolved to remember many things, although for the most part, I don’t remember what it was that I resolved to remember. Peter could have been operating on my big toe for all I cared. Once, I heard what sounded like bone being crushed for what seemed like a long time, and I idly wondered what was happening. I concluded that my face had gotten out of alignment and that he was pushing against my right temple and my left cheekbone to mash it into place. “I thought chiropractors were the bone poppers,” I said to myself before I remembered that the skull is all one bone. “Oh, well, whatever…” I was thinking when Peter asked, “Are you okay?” in a tone that I interpreted to mean, “My god, that MUST hurt!” “I’m loose as a duck,” I answered, only to realize that I should have said goose. Then I thought that maybe I had said goose, but I couldn’t remember.

Another time, I told Peter that I had wanted to stay awake so I could feel like a part of the team rather than like a turnip. He said with sincerity that I was a part of the team, and I replied with equal sincerity that he was a good doctor. The anesthesiologist later told me that I was a good patient, and although we had gotten off to a rocky start, he had kept me out of pain, and he seemed to have softened, so I told him that he was a good doctor too.

So far as I knew (and still believe) there was praise and camaraderie all around, even if one of us was at the intelligence level of a dog—or, more accurately since I am human, a child. I managed to recapture one of the attitudes that children and pets deserve to have. Although they can’t always understand why the grown-ups in their lives do something, they should have every reason to trust that it is the right thing to do. Such trust brings out the best in most people, and there are no crimes so abhorrent as those against children and animals.

Staying awake was a good idea, as I knew it would be. Otherwise, I would have had none of these memories—or any memories for that matter other than of waking up in pain from having been intubated. As it was, I was rolled directly out to be with Peggy. Later, I wondered how I had managed to talk so much while my nose was being worked on, and hoped I hadn’t caused a problem.

The surgery has been over for 24 hours. I skipped a dose of Vicodin because I wanted to see how I felt without it; and I can joyfully report that the pain from surgery is only 10% as bad as the pain I experience everyday. My throat pain is also gone—maybe it was psychological.

I won’t forget Peter Hwang. Really gifted doctors can perform feats that are as mysterious as they are wonderful.