Peggy in Paris

I just talked with Peggy. It was ten p.m. Paris time, and she was on a busy street. Spotlights highlighted Notre Dame; the Eiffel Tower twinkled; and searchlights crossed the sky. A continual din of sirens made me nostalgic for Inspector Clouseau. The CΓ©sar Awards were commencing across the street, and the press of the crowd was threatening to push her off the sidewalk. Peggy didn’t know what the CΓ©sar Awards were, so I did a web search, and told her they are France’s version of the Academy Awards.

I haven’t heard Peggy more excited in years than she has been every time I’ve spoken to her on this trip. It is the excitement of youth, and I miss that in her. When a boy marries a girl, he expects her to remain a girl (all evidence to the contrary notwithstanding) and, as the years past, and she moves ever further from girlhood, he grieves for the loss of his young love. I have often wished during these thirty-six years that I could protect Peggy, not so much from the ravages of physical aging as from the ravages of disillusionment (some of it, alas, caused by me). Disillusionment makes discernment possible, but we pay for discernment with reduced joy. It is the difference between puppyhood and dogdom, and is as sad as it is necessary.

I would have my young bride back if I could, but, to keep her love, I would have to go back too. Only, I was never so young as she, at least in my capacity for joy, because joy requires absorption in the moment, and I could never escape the thought that the moment must end. The frailty of life loomed ever before me, and its poignancy was always by my side.

When I heard her today, I wished so much that I could be there on that noisy, crowded sidewalk, not so I could see France, but so I could see Peggy. Beside her face, a million twinkling Eiffel Towers would be as dim as the cold darkness of space.

the joys of solitude are diminished by the needs of the dogs

What a pleasant morning. I remained in bed a sinfully long time; the sun is shining yet again; I’m listening to happy harpsichord music; and I have absolutely nothing that I must do.

Yesterday was a day of phone calls as a surprising number of people checked-in on me. I was delighted to hear from them, but was perfectly happy to be alone. Sometimes, when Peggy is away, I worry that I will come to enjoy solitude so much that I will dread her return, but, by the time she does return, I am always glad to see her. Meanwhile, it is grand, not having to adjust in the least to anyone else’s needs, schedules, preferences, moods, or requests. Furthermore, I have no meetings this week except for my nerve conduction study, and I am dreading even that. Oh, but if only I could be fully alone—what a joy.

Ah, but my joy was just interrupted in mid sentence. I was on a cancellation list for my sleep study, and someone cancelled, so I will spend the night at Sacred Heart Hospital with wires glued to my head.

Yet again, the dogs are a burden. They will be miserable tonight. They are already miserable. They are miserable because Peggy is gone. They are miserable because it’s pretty weather, and I can’t take them on an outing. They spend their days unhappily dozing except when they’re staring at me accusingly. Three weeks ago, they stared pleadingly, but quickly realized that something was seriously wrong with me. They still know that something is seriously wrong, but they don’t like it. They wonder why I don’t go to the vet and get it fixed, and I can’t convince them that the vet is of no use. A cat in heat could help as much as a vet, and a cat in heat couldn’t help me at all, although it would greatly entertain them. If only a cat would step through their doggie door and be unable to find its way out, they would be happy dogs indeed. Baxter enjoys looking out the window for a few hours each day, but Bonnie has no life apart from her walks and her tennis balls, and she needs me for those.

Yesterday the temperature reached into the fifties, so I put one of my three remaining houseplants out by the curb, and it quickly disappeared. It was a snake plant that I had had for years, so putting it out felt treacherous, the more so because I realized that whoever took it might not want the plant but just the pot. But I had grown tired of caring for it. Now that I can do so little for myself, the more desperate I am to reduce the number of things that require my nurturance. I don’t want to be depended upon by dog, wife, plant, friend, or lodge brother. I don’t even want a book on a shelf to be awaiting dusting unless it is a book with which I truly cannot part.

my recovery continues

Peggy made it to France on only three tranquilizers. I knew she had taken one in Eugene, so when waited to take the other two in Atlanta, I asked her if she was more afraid of crash-landing in the Atlantic Ocean than in the Rocky Mountains. She said NO in a tone that implied it was a silly question.

My Friday doctor’s appointment was actually with his physician’s assistant, and he gave me to the go-ahead to bike and to do pretty much anything that caused me no pain. I therefore took the dogs for an hour’s ride Saturday, and was so swollen and sore afterwards that I’m back on narcotics. Several people called today to ask if I needed anything, but the one thing that I am unable to do for myself is to exercise the dogs; and it is a task for which there are few volunteers. I certainly can’t take them biking again, and even short walks are an ordeal for a man who feels like he has been kicked in the groin.

My moods range from despair to guarded cheerfulness. I spend my time reading, watching old Westerns, and editing old journals. I just started on 2006, the year I had the arthroscopic knee surgery that left me worse off than I had been. I can but wonder if this surgery won’t turn out the same. I know it is unlikely, but then I felt the same way about my knee.

Despite my surgical fears, I made an appointment for a nerve conduction study in preparation for carpal tunnel surgery. The last thing I want right now is even more forced inactivity, yet the higher my medical expenses during a given year, the greater the portion that insurance will pay, and I had planned to have the surgery this year anyway. I am also scheduled for another sleep study (the last one was five years ago). This is something else that was on my list of things-to-do, but now that I having to sleep entirely on my back, I literally wake up more tired than I went to bed.

I still entertain the hope that there is a silvery lining to all these gray health clouds. After all, I am but 58 (at least for a few more days), and am greatly motivated to regain as much vigor as possible. The worst challenge is that I feel forced to turn my surgical care over to people without any certainty that they know what the hell they are doing. If I were rich, I would get four second opinions for every one procedure, and I would fly to the foremost surgeons at the foremost medical centers, but I’m not rich so I must make do.

I managed to limp behind the dogs to the end of the block today, and we passed a string of maybe ten teenagers, each with multiple piercings and all black clothing. Two of them asked me for money for cigarettes, and I wished I could somehow convey to them how few years they can take their good health for granted. In truth, no one can ever take good health for granted, but most of us have thought we could, and decades passed during which it seemed that we were right.

how I pass my days, the joys of Percocet, thoughts on disability and euthanasia

The ultrasound showed the source of my abdominal pain and swelling to be a hematoma. It is large enough to be visible through my clothes, and will have to be excised if it doesn’t dissolve on its own. I was sent home with Percocet and told to alternate between ice and heat. I can neither take walks nor bike rides, and the Percocet makes me unsafe to drive; so I am as housebound as I have ever been. I nap, read, eat, watch squirrels, listen to Baroque music, and, once these many labors have been completed, I beging them again. I’ve read Silas Marner, two books on logic, the 1882 novel John Eax, and parts of other books.

This is not such a terrible way to live when one gets used to it. Friends are solicitous, painkillers make the days run together dreamily, and even a recent sunny day scarcely tempted my thoughts outward. The sun emits a pleasant glow through the window, but the air is chilly, and I am too lethargic to venture out even if I could.

Josh took Bonnie out on Sunday, over did it with her ball-throwing stick, and had to carry her home. He is unable to understand the limitations of a ten-year-old dog, and she is unable to understand that she can no longer run, jump, and make u-turns at full speed. Bonnie and Baxter have both gained two pounds now that I am unable to take them for their daily bike rides.

I ponder the lot of those whom we used to call “shut-ins,” and of what it must be like to lead a life devoid of all ambition aside from passing one’s days in warmth and comfort with plenty to eat. Imagine, no one looking to you to do anything, of no longer having the ability to do anything—at least not anything much. Maybe a hobble down the hallway for stretching exercises, or else a wheelchair ride to the common room to hear a community volunteer play the piano. Then, every other Thursday, another volunteer would arrive with her golden retriever for the residents to pat with the paper-thin skin of their perpetually bruised hands. With the illumination of Percocet, I can see how such an existence might not be so bad—assuming the ability to afford a “nice home” rather than a warehouse where manacled residents with open bedsores slump in odiferous corridors atop squished feces.

But does anyone ever really come to want nothing more than that? With enough drugs, maybe. The power of a pill to alter one’s life is remarkable. Percocet is like a comforting hand, like a voice that says, “Doesn’t it feel beyond heavenly just to lie here, just to read ten pages, nap for two hours, read ten more pages, and then nap for another two hours? How could anyone ask for more? Yes, the world is out there, somewhere, but it’s a crazy and frenetic world—as you yourself have often observed—so why not just let it chase its tail while you lie here in warmth, and peace, and a joy that is as real as it is mysterious?”

Such feelings are one reason I hold back on the Percocet. My prescription calls for a maximum of twelve a day. When I found that I was becoming unable to remember how many I had taken or when I had taken them, I began keeping a record. Most days, I take no more than five, and only then if I really need them to keep the pain from reaching a fever-pitch.

Peggy leaves in two days, and I will miss her dreadfully. I miss her badly enough when I am well and have projects to occupy my thoughts, so how much more will I miss her if the zenith of my capacity is to sit at a desk doing paperwork. She departs on Valentines, and returns two days after my birthday. It is a bitter pill to swallow, but it would be even more bitter if she stayed home to nurse me—as she is even now tempted to do. As much as we love our dogs, we have come to think of them as more a burden than a joy; and I want to do everything I can to prevent Peggy from seeing me in the same light.

I question the wisdom of a person devoting their own life to the deteriorating life of another. Peggy’s father has cared for her mother in such a way for years with no end in sight. I can but wonder at my society’s many contradictions regarding our so-called reverence for life. On the one hand, we are determined to keep every frail, damaged, deformed, demented, and aging human being alive as long as possible no matter what the financial or emotional burden. On the other, we have shown the consistent willingness to send our youngest and healthiest adults to die in foreign lands for reasons that seem nonsensical a decade later. And is it not the epitome of irony that we “put our pets to sleep” because “it would be cruel to make them suffer” even while we denounce human euthanasia and imprison those who help make it possible? So many of the values that are commonly esteemed by my society appear so damnable in my eyes that I don’t feel that I am a part of society, but am instead like one who was caught in a current too powerful to resist.

I storm my surgeon's office, thoughts on being aggressive but not too aggressive

The surgeon said on Wednesday that he would order an ultrasound if the swelling didn’t go down by Monday. Today—Monday—I was at his office at 8:30, because I didn’t want to wait until the phones were turned on at 9:00, be switched to someone’s voicemail, receive a callback at noon, and an ultrasound appointment later in the week.

The staff made much ado about my presence, and insisted that I be examined, first by a nurse, then by a physician’s assistant. I told everyone that I didn’t want to be examined, I just wanted an order for an ultrasound, yet I submitted in the hope that being seen today meant that I could cancel my appointment on Wednesday.

I finally did get an ultrasound appointment for this afternoon. I’m supposed to drink 40 ounces of water one hour in advance and hold it for the half hour exam. Now, does that seem feasible to you? I have every anticipation of (a) running from the exam room or (b) pissing on the table. There was a time when I wasn’t embarrassed by my bodily functions because I thought I was so good-looking. Now I’m not embarrassed because I’m too homely to give a rip. I’m just glad someone else will have to clean up the mess.

Life would be easier if getting medical care didn’t require that I assert myself so much. If I’m too aggressive, the staff balks at my every request, but if I wait passively for my request to be honored, odds are that it won’t be. I suspect there are people who stay home and die simply because they get tired of jumping through the hoops.

Medicine is like the legal system in that it habitually deals with people who are in a horrible predicament, yet it expects those people to behave as if everything was business as usual. This is why I said it won’t do to advocate for oneself too assertively: you are not helped on the basis of need but of influence and likeability—if that. The “if that” arises from the fact that patients are tiny, anonymous, plentiful, and highly expendable cogs in an immense profit machine.

Thirty years ago, I had but one doctor, and his wife was his only assistant. My current surgeon works in an office with ten other surgeons, and I would not be the least surprised but what there are more than thirty clerks, receptionists, schedulers, nurses, nurse assistants, physician assistants, and who knows who else. Most of my doctors have so many examining rooms and so many twisting corridors, that I get lost on my way out. And these doctors don’t even own their practices; they are on the payroll at Peace Health, the same outfit that employs Peggy along with thousands upon thousands of other people, and which expects its doctors to see a LOT of patients. The more patients, the more insurance claims; the more insurance claims, the more money. Tell me, does this sound like an organization that encourages caring, no matter how many crucifixes it glues to the walls?

The surgeon came by my room beforehand on the day of my surgery. I was in the bathroom at the time, and Walt was sitting fully dressed in a chair by the bed. Although Walt weighs twice what I do, and although the surgeon had seen me five days earlier, and had made a big deal about how my thinness would affect the procedure; he still called mistook Walt for me. Our healthcare system is like a conveyer belt, and conveyer belts only work when everyone moves in a straight line.

hell-week

I had hell-week until Wednesday night. I had been in significant pain since Saturday when a lump the size of several inches of garden hose appeared from the top of my incision to my groin. Starting Sunday, I spent most of my time flat on my back—that being the only position in which I could find even a little relief. Monday, I called the doctor’s office only to learn that he would be in surgery all day. His nurse assured me that my symptoms were to be expected since I had lymph nodes removed during the hernia surgery.

I wanted to believe her, but I couldn’t understand why the pain and swelling was getting worse instead of better, and why the swollen area resembled an intestine. No, I thought, it can’t be intestine because the internal repair mesh is holding that in place. Tuesday night, it hit me that the mesh must have broken free, and allowed the intestine to float upwards. I was positively distraught, not so much because I would have to go through another surgery with a less rosy outlook, but because Peggy would miss her trip to France. By the time she got home from work, I was in tears, insisting that she go no matter what, and promising that I would have friends care for me.

Peggy was puzzled. “You never wanted me to go to France in the first place, and now you’re insisting that I go at such a bad time!?” I said that for me to miss her and worry about her while she away was entirely different from me wishing to be the reason she stayed home. She said she would decide after we saw the doctor.

Along with my anxiety over her trip, I was also mad at myself for not insisting that I be seen on Monday. I stand up for myself well except when I’m sick, and then even mundane tasks sometimes overwhelm me. For example, changing my e-mail address this week was a major coup given my condition, and actually facing real people in any situation required so much heroism that I wondered how I ever pulled it off.

Nonetheless, I was unable to think of anything Tuesday night and Wednesday except my appointment with the surgeon on Wednesday afternoon. That I had to do, and I had to do it well, meaning that I had to be prepared to battle for getting the second surgery done immediately, because I knew that Peggy would not leave if it wasn’t behind me. I therefore took a written copy of everything I wanted to tell the doctor. I made the list partly because he is a terrible listener, but also because of my problem with remembering things when I am in pain. Although Peggy would serve as my backup, I knew that I could stand up for myself if only I could marshal my resources.

The surgeon read my list, examined my belly, said he thought the swelling was fluid and that my pain was caused by going off the Vicodin two days after surgery: “Pain left untreated feeds on itself.” He also said that the possibility of a mess failure was “too insignificant to consider.” As for my list, he admitted that it had grabbed his attention, but he said he was sorry that I felt the need to grab his attention. I was sorry too.

The Percocet helped so much that I couldn’t believe how much it helped; and the surgeon’s assurance that my problem wasn’t dire was an even bigger help.

Now, I’m happy, and Peggy’s happy. Peggy is also excited about her trip actually coming off, having passed through, first, the cancer scare, and then the failed mesh scare. I am also resigned to the necessity of letting Peggy do things for me until her departure. Oh, but how much easier it is to be the helper than the helpee, because the latter feels humiliating despite my knowing that we all have to endure it at times. The greater my need for help, the greater my resistance to accepting it. This, I’m sure, is my real weakness, for I would never make the same judgment against others that I so readily make against myself.

the surgical holding area, the strength of old ladies, I make my incision swell, my father's stubbornness

Rain all day, as usual. Last Sunday—the day before my surgery—we had five inches of snow—a phenomenal amount for the valley floor—and I spent the day clearing it from the patio roof.

After I checked into the hospital, I was taken to a room that held six patients. Curtains offered visual privacy, but there was no verbal privacy. My surgeon was running two and a half hours late, so I saw other patients come and go. One was 88, and had suffered for nine years from infection following a knee replacement. He was there to have the joint removed and the space packed with antibiotics for three months. Then would come another replacement and, if that didn’t work, a fusion. He was sharp of mind and did his own talking. We were taken to the surgical holding area together, and, as he was wheeled into the O.R., I kept thinking, “You are screwed, dude; you are not going to survive this at your age.” Then I realized that he was probably screwed anyway.

Every day, I watch Mrs. Fredericks walk by. She is 90, lives three houses down, and lost her husband to diabetes last year. A few months later, her daughter and a couple of her grandkids were killed in a plane crash. She stays in her house until she “can’t stand the loneliness anymore,” and then she walks. I ponder the pain she suffers with every faltering step, and I wonder how much longer she can holdout. We denigrate men by comparing them to old ladies (“an old lady could run faster…lift more, etc…than you”), but old ladies usually live to see their once strong men dropped into holes.

I feel sicker now than I did the day after surgery, and I finally figured out why. It’s because I am forced to sleep on my back, and my sleep apnea is worse that way. Last night, I had dream after dream in which I was trapped in dark, dank, putrid rooms without enough oxygen. The constipation came back with a vengeance too. I lay awake most of the night reading Silas Marner.

This morning, I decided I was babying myself too much, and that I might feel better if I did some light housework. I unthinkingly lifted two empty backpacks from the top of a closet, and the area around my incision swelled alarmingly, forcing me back to bed. Peggy was in tears for worry.

Walt stayed with us at the hospital all day Monday, Shirley brings us food every morning, and others have reached out too, but I feel too vulnerable to open my heart. Instead, I am more annoyed by their faults than usual, and can hardly be civil. I am surely a difficult person to befriend, much less to be married to. But then aren’t we all, more or less? Maybe the human race is perpetually at war because we are too obnoxious to tolerate ourselves.

Peggy, I can tolerate better than usual, partly because I see how hard she is trying to help me, partly because I am in no shape to be argumentative, and partly because I see how hard things are for her. I don’t know how people who live alone are able to survive life’s travails, but, come to think of it, if Peggy were alone, she would be free to go to France.

I want Peggy to go to France no matter what, but Peggy wouldn’t be able to enjoy France no matter what. This makes me even more regretful of my foolishness this morning. I wanted so very much to not feel helpless that I made myself more helpless. Every year finds me longing for my comparatively strong body of the previous year. I apprehend further deterioration, and will have to grow stronger of mind if I am to survive.

The surgeon’s nurse said he might want to do further testing for cancer despite the biopsy coming back normal. Why didn’t he think to do “further testing” when he had me cut open on Monday? I seldom go to a doctor but what I leave less enchanted. As a group, they know so little, and most of them know even less than that. Besides, their services are so half-assedly rendered that I can but conclude that money is the main motivator. A five-minute visit costs $200.

Peggy and I tried to hide the cost of my father’s pills from him, but when the day came that he found out, he argued that if enough people chose death over “highway robbery” that medical costs would come down. This is probably true, but how few are willing to volunteer.

Everyone dismissed my father as a stubborn fool. I knew his faults better than most, but I have also observed that normal people don’t achieve sainthood. You’ve got to be a hardcore hard-ass to be a saint and, for better or worse, my father was that.

fun times with Vicodin

The lymph node biopsy came back negative, but now the surgeon wants to biopsy the other side.

I had an iodine-contrast CAT scan yesterday to look for a reason for my partially collapsed lung. Preliminary blood tests were ordered for the day before, and I was in a lot of pain when Peggy drove me to the internist’s office. I had called twice to verify that these tests hadn’t been run as a part of my pre-surgical blood-work, but Peggy asked a third time when we got there, and was told that they had. The nurse had an “Oh, well, shit happens” attitude, about it, so Peggy complained to the practice manager.

Another nurse promised me that we wouldn’t be charged for coming, but I stopped at the front desk to verify it. She appeared while I was there and, looking hurt, reminded me of her promise. I couldn’t very well tell her that I no longer trust anyone in the medical community to get anything right.

I took full advantage of Vicodin for the first two days. Even with it, I hurt too much to sit up for long, but time passed pleasantly enough in bed with an ice pack on my groin. I was determined to read a book on informal fallacies, but I dozed off so often that I re-read most of it twice.

I was just starting to understand how people get addicted to painkillers when the side effects hit. I hadn’t pooped in three days and was eating heartily, so my weight shot up an incredible ten pounds, and my abdomen became as rigid as it was bloated. (When you’ve had hernia surgery, the last thing you want to do is to strain to poop.) Then came the itching. No sooner would I scratch in one place than it would start in another, and I was soon itching in way more places than I had hands to scratch. Last—but not least—I was forgetting to breathe. I would be feeling all happy and mellow, when all of a sudden I would gasp for air, and realize I had missed a few breaths. It was like sleep apnea, but I was doing it while awake. I can’t say enough bad about how this feels.

The surgeon’s nurse advised that I cut the Vicodin in half, but I decided to simply endure the pain. I thought that, being two days post-op, it just couldn’t be that bad. It was. Now, four days post-op, the pain is so intense that I have trouble walking. It is worst in my privates, which are purple and swollen.