Today's barely edited

I didn’t feel old until a year or two ago. I attribute this sudden oncoming of antiquity to the pain. Except for misdiagnosed sleep apnea (which cost me two needless surgeries) and the pain of the last six years, I’ve been healthy as an adult. In fact, I used to marvel at my good health because I would — sometimes for months—feel such sadness that I was just sure it would eventually eat its way from my heart and into my flesh, causing me to sicken and die. The fact that I stayed in such good shape was curious to me.

Then came the sleep apnea, and I grew increasingly desperate over a period of five years until it was diagnosed and treated. Three years later came the pain. For the longest, I thought I would beat it. I told myself that my species, despite its many faults, is very clever in various ways, and that medicine has been one of the major benefactors of the explosion of knowledge that has occurred during my lifetime alone (I would have died had the sleep apnea hit 15 years earlier). How hard, therefore, could it be to eliminate my little old pain? It might be impossible as it turns out.

For much of my life, I held doctors on such an intellectual pedestal that if a doctor couldn’t cure me of something, I would assume that he wasn't trying hard enough—maybe he hadn’t run the right test or asked the right question. I later met doctors whom I trusted as good men as well as good doctors, and when they told me there was nothing they could do, I believed them. Even with this recent pain and the urging of one reader to see a pain specialist, I have no thought of seeing a doctor. For what? Pills? I’ve got pills, and if there were other pills, I would know about them. Dosages? If I want to dicker with those, I have more confidence in the Internet than I do in any given doctor (I've discovered two serious errors in my prescriptions by looking them up on the Internet). Tests? Diagnoses? Surgeries? I could probably get several more of each if I wanted to start from scratch with new doctors, but I don't.

Maybe my "barely edited" experiment is connected with my need to transcend the pain because while I've lost all hope of escaping it completely, I haven't lost faith in my ability to someday live well despite it. I think at least one of you might have worried about me euthanizing myself after my last post, but I wouldn’t do that. I thought a lot about it for a long time, and I must have decided against it because I don’t dwell on it much. Not that I was ever really close to suicide; it’s just that I considered it a reasonable and reassuring option. If you hurt as I do, and you killed yourself, I could respect you for it if you only had yourself to think of (If you were married, I would consider it necessary for you to get your spouse's blessing to kill yourself it unless your spouse opposed suicide on principal). But even if you were alone or had your family’s blessing, I would suggest that you hang in there. You’ll be dead-meat in a few years anyway and you'll stay dead for all eternity, so why not stick around? You might do some good, you might have a few laughs, and you can always decide to off yourself later.  

The photo is of me, from yesterday. It did me good to go to the woods.

Bella

I called Mark’s office (Mark is my orthopedic surgeon) on Tuesday saying that my pain level was through the roof, and I needed to see him. His assistant called back and said that Mark didn’t think that would be necessary. I was seriously perturbed, but decided to give the pain another day or two before I insisted on coming in.

Peggy went out of town on Wednesday, which was just as well because I was awake nearly all night Wednesday night. I repeatedly lay down, but each time I did so, the pain drove me up again before I could get to sleep. Over a period of five hours, I took twice the prescribed dose of Dilaudid plus the maximum doses of oxycodone and Neurontin. I also drank some vodka, but I still couldn’t quiet the pain. It was a long night indeed, yet I wouldn’t say that it was an altogether bad night because, over the years, I have discovered within myself a fortress of serenity and optimism that the pain cannot penetrate. I don’t mean to brag, or to say that no amount of pain could reach it, yet I often stand amazed by my ability to remain upbeat against such a raw, unremitting, stabbing force.

I called Mark’s office Thursday morning, and was told that he could see me at 1:00. I worried about driving after taking so many drugs, so I asked Bella (at 87, she’s the oldest member of my atheist group) to chauffeur me. Mark checked me over pretty good, and then said that my excessive pain was probably caused by two things. One was overdoing my new exercises last week, and the other was the fact that narcotics simply don’t work for me anymore.

“You’re saying what I hoped you would say,” I offered (I had been afraid he would have to redo the surgery), and then I told him about all the drugs I had taken the previous night. Before I could finish, Bella chimed in, “Tell the doctor about the vodka. He’s not supposed to wash his narcotics down with vodka, is he doctor?” “Oh, my god,” I thought, “I’ve found myself a Jewish mother, and I’m not even Jewish.” (I think Bella was disappointed that Mark didn’t give me a hard time about the vodka or about piling on the narcotics.)

As we were leaving the office, Bella twice observed, “He’s really good looking, isn’t he?” Well, the truth is that I almost didn’t go to Mark because in his picture, he looked like what he is, a jock. Yet, I get along with him about as well as any doctor I’ve ever had. Two hours after I got home, Bella emailed me a list containing everything Mark had suggested. My new Jewish mother is just too cute.

I’m glad I’m practiced in misery

The day after I last wrote, my pain level went through the roof and has stayed there, prompting me to take a phenomenal number of sleeping pills and narcotics. The worse case scenario would be that I tore the tendon that had to be temporarily detached during surgery in order to reach the joint. This fear of re-tearing tendons is a major stressor that goes on for months following shoulder surgery. I’ll give the pain two more days before I call the doctor.

Fortunately, pain doesn’t get me down as bad as it once did. I well remember the days when I would sit in my recliner (I had to sleep in a recliner in order to sleep at all) in the wee hours and worry that if the pain got any worse, I would become hysterical. As you might imagine, that fear was harder to survive than the pain itself. Now, that I have a long record of survival, I can reassure myself that it’s unlikely that anything like that will happen.

Another interesting aspect (interesting to me, anyway) of all that I’ve been through is that it has probably left me less depressed than I’ve been in years. I certainly experience anger, fear, and sadness, but not ongoing depression. During the London Blitz, psychologists found that the depression rate of Londoners actually went down as their city collapsed around them. Obviously, that was a very different situation than my own, yet one commonality might be that pain and fear trump depression. After all, depression requires reflection, and reflection requires that one’s basic needs be realized.

Even among WWII concentration camp survivors, there appeared to be little clinical depression, presumably because the people were too busy surviving fear, sickness, overwork, exposure, and starvation, to ponder their deeper feelings. So it was that the suicide rate appeared to go up after liberation when the former inmates had sufficient comfort and leisure to consider the meaning of what they had suffered, and to mourn for what they had lost in terms of family, friends, wealth, and opportunity.

Surgery day

I told the nurse that the patient whose room she had sent me to wasn’t Peggy. She said that it was Peggy, but I still had to look at the old, pale, and puffy woman in the bed for awhile to be sure (I had told Peggy just before her surgery that she looked sexy in her purple hospital gown--which she did). My advice to you is this: if you’re supposed to be in a beauty contest one night, don’t have surgery earlier that day.

While I sat by Peggy’s bed, I pictured us when we were in our twenties, holding hands while we ran for joy across the prairie in Saskatchewan (I remember that day because we were nearly struck by lightning). Now, we hold hands while we hobble into doctors’ offices. Well, we don’t exactly hobble, but we’re getting there.

The universe never promised us an easy life.

The universe never promised us a happy life.

The universe never promised us a peaceful end to life.

The universe doesn’t even know that we exist.

We live for no purpose, and then we die, and the fearsomeness of this thought is why people believe in god.

I’m scheduled for my first of four joint replacements, which means that Peggy and I will be one-armed together. The surgeon and I all but argued—over Peggy’s bed, no less—about which hospital to use for my surgery. I said I wanted to go to Sacred Heart because I could have a private room at no extra charge, and he said he could use his influence to get me a private room at McKenzie Willamette at no extra charge (I have good reason for wanting a private room). “Besides,” he said, “I can give you far better care at McKenzie Willamette.” “Then it sounds like a no-brainer to me,” I said.

Peggy is resting now. I held her hair out of her face while she threw up. How many times have I done that over the last four decades? I’ll tell you. Many.

I just took two stiff drinks. I hurt so much that it’s hard to care anymore what I take or how much I take as long as it stops the pain. I’m not supposed to take narcotics until after my surgery because if I do, they won’t work when, presumably, I need them most. Well, hell, they don’t work that well now. Nothing works that well now, but if I pile pill atop pill and use ice, I can at least sleep a little bit before I have to get up and do it all again.

You don’t think I complain too much, or that I complain without a good reason, do you? Pain is such a private phenomenon that I often wonder where I am on the scale of having a justifiable response. This might surprise you, but I think I handle pain better than most people, but it’s hard to know for sure.

I read from Camus’ The Stranger while I sat by Peggy’s bedside (the morphine made her doze, so I had a little time on my hands).

“He was wearing a soft felt hat with a round crown and a wide brim, a suit with trousers that corkscrewed down around his ankles, and a black tie with a knot that was too small for the big white collar of his shirt. His lips were trembling below a nose dotted with blackheads. Strange, floppy, thick-rimmed ears stuck out through his fine white hair, and I was struck by their blood-red color against the pallor of his face.”

When I was young, such passages were about someone with whom I had nothing in common. Now, they’re about how I will be in fifteen years. Sometimes, I wonder if I will even live another fifteen years. Come to think of it, that’s about the length of a dog’s life—if the dog lives to be fairly old.

Nurses can tell that I adore Peggy, and that touches them. I asked one of Peggy’s nurses today if she will be my nurse when I have surgery, and she gave me her home phone number so I can be sure she’s working that day. She said that if she’s not working that day, she’ll refer me to someone who is. Now, I have my surgeon, my anesthesiologist, and one of my nurses all picked out. My advice to you is this: if someone is good at what they do, stick with that person, and let them know that you respect them. You get better service that way. As you know, I was kidding about the beauty contest, but I’m being serious now. While I’m giving you advice, I’ll also suggest that you praise good workers to their supervisors. One reason for this is that they’ll feel beholden to you, and the other is that you owe it to them.

Do ever feel when you’re writing that, after every paragraph, you could go in a dozen different directions. How do you choose? I choose really fast because otherwise I get too bogged down.

Those two drinks—taken on an empty stomach—were too much. I thought they might be, but I found it hard to care. Now that I feel as if I too could barf, I do care, but it’s too late. Most wisdom comes after the fact, but since the rules about a lot of things are forever changing, after-the-fact wisdom isn’t necessarily better than no wisdom at all.