Early Blogs #10 & #11 (You Gotta Go When You Gotta Go)

Here are two more of my earliest blogs from two years ago, ten days after my first brain surgery:

THURSDAY, OCTOBER 15, 2009 7:09 AM, EDT

7:30am, Thursday morning. I’ve gone on a few tangents and it’s time for another funny hospital story. In a minute.

I woke up around 6am, and came downstairs. Even Noah, who usually skitters up to go outside the moment I wake, lay motionless in the front hall. He tipped his head briefly as I passed, as if to say, “Are you kidding me? Why so early?” He dropped his head back, groaned, but was up following me in a few minutes.

I opened the front door, retrieved the papers (NYT, WSJ) and there was also a package on the doorstep, a medium cardboard box chilled by the night air. It was a gift box from family, filled with favorite jams, grilling sauces and dried cherries from my favorite purveyor up north. (If you are family and reading this, this does NOT mean you have to send me something now. Seriously. Put away the credit card.) I got things SET for the morning, what I love about first things in the morning, so orderly. This morning I felt normal, not dizzy once.

Kettle on. Noah pills. Noah Kong. Noah outside. Noah inside. Noah banana. Noah rests. Open papers. WSJ to MJ’s spot, topped with NYT “Thursday Styles” section. Open NYT to Arts section. Cut out KenKen puzzle for MJ. Crossword folded precisely for me. Papers down, laptop open. Water boiling. Tea. Sit. Begin crossword. MJ’s footsteps upstairs. Perfect.

This morning my stitches come out from my spinal tap, so I’ll be leaving to see the surgeon in a few minutes. It makes me think about hospital life and things we take for granted at home. Simple things you can do yourself. I have a funny story to share about this, and I’ll finish and post it when I get back from my visit with the surgeon this morning.


THURSDAY, OCTOBER 15, 2009 6:49 PM, EDT

Back from getting my stitches out. (MJ drove me.) This includes my funny hospital story, but first this. It was nice going through town, seeing the leaves beginning to change colors. Since the tumor came out, my senses are heightened. I am color-blind (red-green) but I still “see” colors, especially when they are not too mixed up. Colors pop now, my eyesight sharp as ever. Ten days ago I was strapped to an operating table and pieces of metal were going inside my head. The turnaround is amazing.

My sense of smell is heightened too. It is so magnified I wonder if I ever had olfactory senses as good as this. Everything smells sweet. I’ll never know how long I had that golf ball of tissue hogging up space behind my sinus cavity. For years, perhaps, something had stood in the way between a nice aroma and my brain. I love a small glass of Vintage Port now after dinner, just smelling the nuances endlessly, hardly needing to sip it. When I was building my wine cellar I would on occasion buy a few bottles of good Ports as they became available in so-called “vintage” years. It seemed prudent; Port was out of favor, dirt-cheap, took forever to age (no danger of them going bad), and the experts raved about the quality. It was a no-brainer even though I wasn’t sure I liked them that much. But I accumulated a small collection over time, shrewdly, just in case, buying the very best bottles at just the right prices. Though in the past I have tasted great Ports with my wine friends, I have never until now appreciated them so much. In a way, like the peppers I grow, a great bottle of Vintage Port is yours; it will contain all the sensations of things you remember while the wine was aging along with you in the bottle.

My hearing is good too. No ringing anymore. As I write this, I can hear the strains of the “God Music” movement from George Crumb’s “Black Angels” string quartet MJ is rehearsing upstairs with colleagues. In this part of the piece, an ethereal cello solo floats quietly over bowed crystal glasses providing a celestial hum. I now realize this is the otherworldly sound I was unconsciously thinking of when I wrote the piece in memory of my mother for her memorial service. In my piece, “Memory Box,” MJ and I were stationed on opposite sides of the stage, each of us running our wet fingers atop crystal glasses as percussionists on stage played groups of sounds representing fleeting moments I remembered about her, the most I could come up with at the time.

I promised a funny hospital story, so here it is:

In the critical care unit, I was in bed. The entire time I was attached to wires and tubes, blood pressure cuffs, catheters. In the critical care unit, make no mistake: you are ATTACHED. It seemed a machine beeped every time I moved. They wanted me lying there like a corpse, best I could figure.

My constant urination, thankfully, was no problem. In fact, it was liberating to have a catheter. My tumor removal led to a lot of bodily fluid upheaval and they needed to keep precise track. Every hour a nurse came in, emptied my bag of urine and noted the amount as well as my spinal fluid level and how many glasses of liquid I had consumed. They made constant adjustments to the bags, my bed level, and a column manometer.

But the thing about a catheter is, while freeing, it takes away your sense of control. Urine simply drains away. You hear this whooshing sound every once in a while, but you never experience the variation of the (probably male) Cartesian moment where you declare, “I go, therefore I am.”

After a few days of this odd freedom, you remember there’s also a number two. Seriously, I had forgotten all about that part. In the beginning I ate sparingly, and it wasn’t until Thursday that I wondered what I might do about a bowel movement. Thursday morning (the third day) a lot of things changed: my sinus packing was removed. I could BREATHE. I was alive again. After a mid-afternoon Dilaudid nap I woke up famished. Ravenous, actually. I grabbed the phone and ordered cheese tortellini with Alfredo sauce and a cherry cheesecake. Friends were coming to see me in a few minutes and I needed energy. Still needing to lie horizontal, MJ fed me one small piece of the tortellini at a time. But halfway through the plate, I didn’t want anymore. Things were moving and shifting inside me. I asked for a bite of the cheesecake, thinking it might help. Nope.

I had to go right to the bathroom. But I was tethered up the wazoo to my bed. The nurse looked over my directions and said I was not allowed out of bed yet. She could bring a bedpan, and maybe I could squat? My friends were halfway up the elevator. She gave me the bedpan and I just vomited in it.

A little while later they unhooked me while my friends were still there. I tried for a while, but the moment was gone. They put me back in bed, shot me up with more drugs and I slept until I woke in time for shift change.

Shift change at the new hospital wing (where I was lucky to be) was always a model of professionalism. The outgoing nurse stands face-to-face with the incoming nurse, both with laptops sitting atop lecterns, as if ready to debate one another. Like co-pilots going over a pre-flight checklist, they methodically go over my case bit by bit. It was always a perfect handoff as far as I could tell. Notes were scribbled and erased on my bulletin board. Then I noticed a new space near the bottom, previously unfilled:

Goal: [Arrow up symbol]

When the shift change was complete, I spoke to my new nurses for the night (you always have two in critical care, I think). Primarily I would be dealing with Heather, a sweet ingénue. She reminded me of the character Pam from “The Office,” especially her voice, and she nodded her head understandingly at everything I said, sometimes before I had said anything.

And then I met my other nurse, Sylvester. He was a strong black man. He seemed—and pardon me for saying this—just like the kind of stock character inserted into a movie who served the sole purpose in the script of helping a white person get over self-esteem issues. Before any introductions, he spied the up-arrow written in the “Goal” line on my wall chart. He made his eyes into perfect circles and pointed straight at me.

“We gonna get you UP. First you SIT up for a while. Then we walk to the DOOR and back. Later we’ll walk INTO the hall. Later still we’ll walk all the way to the END of the hall and back. Okay?”

“Okay,” I said.

He disappeared and I resumed my chat with Heather. It came up that my job was to play oboe with the Grand Rapids Symphony.

“Oh my GOD!” she said. “I LOVED going to the symphony when I was a student.”

“The Student Passport Program?” I asked her.

“YES!” she said. “It was so GREAT! All my friends too.” She rattled off the selling points for me: “Student ID. Best available seat before curtain. Only five bucks!”

“And just who do you think came up with that brilliant idea?” I pointed at myself and cleared my throat triumphantly.

“No WAY!”

“Absolutely,” I said.

In fact, I was lying. I am a zealous believer in this program—I speak of it often—but I didn’t invent it. I lied because she was going to make judgment calls on my drugs all night and I wanted her under my control.

She also saw I had a crossword next to my bed.

“You can DO those?”

“I’ve done every New York Times and Wall Street Journal crossword since 2005,” I said. (This was true.)

“I’ve tried, but I have never finished even one. You can do the New York Times? Those are the hardest!”

“I can, but you can too,” I said. “Start with a Monday. Spend all week on it. Use Google. You’ll finish. But only do the Monday ones for a while. I know you’ll be able to do it.”

“Really? Me?”

“Of course,” I said.

“Wow.”

“Say, how am I doing on drugs right now?”

She looked at her screen. “Oh, uh ... you can have a Norco now. Two if you want. And”—her eyes scrolled down a bit more—“I guess as much Dilaudid injections as you want to fill in the cracks." She sort of shrugged. "That’s what it says. Need anything?”

“Mmm, I’ll start with a Norco. Then let's add little squirts of Dilaudid here and there to keep the rabbit holes open.”

“Okay.” She opened the safe, took a pill out of the foil casing and brought it to me with a new cup of water.

“Thanks.”

Sylvester came back, saw I was lying down, and left.

I thought for a while about the rapid changes in my body today and said to Heather, “You know, if I’m allowed out of bed, I’d really love to be in the bathroom by myself for 30 minutes. No pressure.”

I arranged myself on the side of the bed, ready for help standing up. Heather did all the clamping off of tubes and wires. Sylvester came into the room to escort me to the toilet. Heather's only job, apparently, was to trail behind me. Mind you, after three nights in bed, my gown was totally open in back, but I’m sure it was nothing new to anyone in that profession.

As Sylvester sat me over the porcelain, he arranged a mini table in front of me on which he placed a newspaper, a hand towel, and a puke bucket. He also hooked my hand to the emergency pull string.

"I'm all set," I said. "Thanks!"

"Water!" he said. "You'll need a COOL glass of ICE water at the right moment!" He disappeared, leaving the light on and the door to my bathroom wide open, out of my reach.

He didn't come back. I didn't know what to do. Five or ten minutes later, still trapped over the bowl, I spoke a soft, "Hello?" Then I said, "Hel-loooo?" more loudly.

I heard Heather's timid voice reply, "Yes?" (Was she sitting in the room the whole %@#!$%* time?)

"Uh, Sylvester went off to get me some ice water and I don't know where he went. Can you just pour me a glass of water from the tap, then CLOSE THE DOOR so I know I'll have total privacy for a while? For like a long, long while?"

"Oh, sure," she said. I heard the tap running in my room. Her hand reached inside. I grabbed the styrofoam cup. She clicked the door closed.

Peace. I began reading the New York Times. Anything would have sufficed, even the phone book. I relaxed. My own private space.

The door swung open. It was Sylvester. "I almost forgot your water, man! Here's your . . . hey! You got a water!"

"Yes," I said.

"You want me to take that one away and leave this one?"

"No, that's fine. Just leave them both. Everything is perfect. Perfect, perfect. Thank you."

He took a step back and seemed to assess my vulnerability for the first time. "Ohhhh, I see. Awright. I got you.” He leaned in conspiratorially. “Don't you worry. I got you covered. I'll be right OUT-SIDE. No intruders now, heh HEH! You have yourself some PRIVATE time here, heh HEH!"

I said, "Just a closed door. Just silence. Thank you so much." I smiled and closed my eyes in peace. I was so ready to go number two so naturally right then. I was almost ready.

Sylvester added, "You know, and don’t you worry about that catheter, about that tube hangin' all over the place. It may go this way and that, but don't you go feelin’ like you peein' all over the place. Heh HEH! It could wrap around your leg like some barbershop pole and make no difference!” He snickered once more—“Heh HEH!” and closed the door.

Now I had that to think about. The barbershop pole around my leg dripping urine. My strategy for number two has always been consciously to release number one first, then number two. In order, by my command. With the catheter, I had no way to will anything to be so.

I heard a whisper. "Hey Al . . . Al . . . AL!!" It was Sylvester from the other side of the door.

“Yes?”

“All clear. Just you and me. Do your thing. Nothin’ but time.”

It was never going to end. I finished the article in the New York Times, and, true to his word, there was nothing but a long, respectful silence from then on. But I never knew if I was alone. The only way to confirm this would be to whisper out the door, but that might strike up another conversation with Bagger Vance out there. I tried drinking the water. Nothing.

I was out of options. I stood up, tied my gown, took my newspaper, flushed the toilet, and pulled the emergency call string.

No response.

I used the handrail to guide me in my dizziness to the door. I opened it. It was dark and no one was on the other side. It was four feet of open floor space to my hospital bed. I steadied my hand on the wheeled IV pole, pressed it into the ground for stability, and took the few steps to get me to bed. I made it. A moment later, Heather came into the room.

“You made it back to bed!”

“Yes,” I said.

She rubbed one index finger over the other. “I’ll give you a symbolic bad, bad, mister!” she scolded. “You shouldn’t do that by yourself.”

“Okay.”

“Any luck?”

“No, not this time. But thanks for helping.”

She hooked up all my tubes again. “Ready for sleep?”

“Sure.”

She walked to the cabinet and opened the safe. She withdrew another Norco pill and a syringe filled with Dilaudid. The room was dark and I could see her glistening eyes pierce into me as she approached. She was no ingénue anymore, I can tell you. This was an adult woman, a professional, trained nurse with intent. As she traversed the darkness of the room I imagined hearing only the click-click-click of her heels as she approached. High heels. I drank down the pill. She injected my IV and soon I felt the cool liquid spread up my right arm. In a moment, the drug was in my brain and the walls melted while electric hydrangeas bloomed. I could have gone to the bathroom right then, perhaps, but I fell asleep.