Gym Dandy

My siblings had done a lot of research before selecting Silver Lake as the place where I would continue my recovery. It had an excellent reputation as a facility for respiratory rehabilitation, and they were famous for their ability to wean patients off their trachs. The first time a physical therapist came to see me, we practiced walking. I used a walker and made it from my bed to the door which was a big deal, considering how in the hospital I could barely get out of bed. When she left she said she'd be back the next day. It occured to me that if they weren't going to let me out of my room because of my MRSA, the fact that they had a state-of-the-art gym on the premises was not germane to my rehab. It seemed pretty ridiculous. There was only so much I could accomplish in my little room. I guess they figured that out on their own, because in another day or two they wheeled me down to the gym, but they insisted I wear a surgical mask. When I saw the gym I was sorely disappointed. State-of-the-art? There was one old stationary bike, two pulley system weight stations, two parallel bars set up about four feet apart for people to practice walking, some stairs and some occupational therapy equipment. That's about it. Everything I did, I did while connected to an oxygen tank. They had me walk the length of the hall that led into the gym and back. They had me do some leg strengthening excersizes while wearing ankle weights. Sometimes they had me climb the stairs. I found it all very pedestrian. After going to rehab every day for about a week, I was bored senseless. They came to get me every day at around 2:00. I started feigning sleep. It didn't work...they woke me up. The bottom line is, however, that although I look back and make fun if it, here I am all these months later and I can walk. I still have that little hitch in my gait because of the still-not-totally-resolved drop foot, but I am ambulatory nonetheless. And the strength has returned (to some extent, anyway) to my arms and legs. Despite equipment and surroundings that I found less than stellar, I was extremely motivated and accomplished a lot. For that I am truly grateful.

Joe

My roommate, Joe Manzini, was 79. He had prostate cancer, was incontinent and had just recently been weaned off a trach. Joe had been a heavy smoker. I say had been, but in fact he was still known to sneak a cigarette outside on the patio every now and then. He was a bachelor and had virtually no family except a nephew that visited him once in a while. Joe had been at Silver Lake for seven years. Seven years! I really felt sorry for him until I realized what a pain in the butt he was. The reason we were roommates was that we were both in what they call "contact isolation." I had MRSA and I think he did too, or maybe he had some other communicable disease, I'm not sure. In theory anyone walking into our room was supposed to don a mask and gown, but that almost never happened (in the ICU these rules had been adhered to religiously) . Anyway, Joe would wake up every morning and watch "The Sopranos". We each had a TV mounted on the wall in front of our respective beds. Apparently Joe was a little deaf because when he watched TV the volume could have awakened Jimmy Hoffa. And we were nowhere near Giants Stadium. So every morning there was a kind of "dueling broadcasts" in our room: it was "The Sopranos" vs "Pet Star". Then one day Kalman had the fantastic idea of bringing me the wireless headphones I used for my stereo at home, and they actually worked with my TV. I was able to hear well and block out Tony & Co. at the same time. Brilliant!
Because of his surreptitious smoking, Joe was getting worse every day. He was finally sent to Richmond University Hospital for about a week. When he got back, he was not the same guy. He didn't know where he was and didn't remember the names of nurses who had cared for him for seven years. He talked to himself a lot during the day, but at night he almost never shut up. Now, it's hard enough to sleep in a hospital or nursing home, what with nurses roaming the halls and the sound of call bells and ventilators filling the air. It's damn near impossible with a delirious old mafioso yakking all night about Big Nicky and Vinny the Moustache. It's a miracle I didn't strangle Joe. While he might have been a dangerous tough guy in his youth, somehow I never feel threatened by anyone wearing a diaper. Anyway, he talked about his years in the navy and when he met Frank Sinatra at his niece's wedding and all kinds of juicy stuff. It actually might have been somewhat interesting in a different context (even if a lot of it was baloney), but not at three in the morning.

R2D2

I was still oxygen-dependent. Nursing homes don't have oxygen dispensers built into the walls like hospitals do. Instead they use concentrators like the one on the left. Concentrators suck in regular room air and remove all the nasty things like nitrogen, argon and carbon dioxide (and, presumably, bird dander, had there been any) and deliver 100% pure oxygen to the patient. Supposedly. More than one nurse has voiced her doubts to me about this remarkable alchemy. So of course I was hooked up to the concentrator. The tubing was attached to my neck and aligned with my trach so that the oxygen would proceed directly to my lungs without passing "Go" or collecting $200.00. I named the little guy R2D2 because that's what he reminded me of, and he became my constant companion. He ran 24/7 and helped me breathe. And he was a better conversationalist than Joe. Bear in mind that at this point I still couldn't walk or breathe on my own, so R2 and I were basically joined at the hip. My little buddy supplied the oxygen I needed, but he couldn't fix everything. At the risk of getting a bit gross, I had loads of sputum (or is it phlegm? I don't know the difference) in my lungs, most of which I could not cough up on my own. Whenever that happened it was suctioned out by a nurse. They stuck a tube into the hole in my neck that was attached to a kind of vacuum and literally just sucked all that nasty stuff right out. Every time they did it I gagged, so it wasn't particularly pleasant, but it did make breathing a lot easier. Only problem was, the gunk that was coming up was bloody. Apparently at this point in my recovery it shouldn't have been, because the staff seemed concerned about it. Turns out they were right.

Somewhere, Over the Verrazano...

I was positively giddy in the ambulance. Imagine: five weeks before I was lying in a coma with some of the best doctors on the planet unwilling to predict whether or not I would survive. I went through hell and now here I was...discharged! I was euphoric. It felt like nothing less than emancipation. It must have been around 10:00 when we pulled up in front of Silver Lake Specialized Care Center in Staten Island. Wow. Doesn't that sound classy? This facility would be my home for a week or two (yeah, right), just a way station between the hospital and Flatbush. My brother Vrumi and his wife Raizel were there when I got there. It was nice to see familiar faces. I was taken to my room and introduced to my roommate, Joe Manzini. More about Joe later. The room was drab, stuffy, utilitarian. Depressing grey walls. My euphoria started to fade. Then the nurses came in to change Joe's diaper. Joe was 79. I think at that point the last vestiges of my euphoria took a powder and the reality of the situation hit me hard: I was now a resident of a nursing home! "Specialized Care Center" sounds better, doesn't it? Suddenly there were four nurses surrounding me. Two of them, Donna and Maria, would soon become more than nurses, they turned into trusted friends. But I didn't know that now. They were there to do a body check. A what?, I said. It's just what it sounds like. They check your body. Your entire body. Then they document any rashes or scratches or bumps or bruises or garden-variety boo-boos. Now as you know, I had been seen in various stages of undress by scores of women, men and others in the ICU. This newest invasion of privacy shouldn't have fazed me one bit. Somehow, it did; somehow, it was different. In Columbia Presbyterian the nakedness was just a bi-product of one procedure or another, or a necessary evil in order to keep me reasonably clean. No one was paying attention to my body. Here, the whole point was to pay attention to my body. I was absolutely mortified. So I dealt with it the way I usually do when I'm naked in front of four women: with humor. I cracked jokes about my adonis-like physique in a classic defensive move (I'll make fun of myself before they get a chance to). It loosened up the atmosphere in the room. I'm sure a lot of the people the nurses do this to are either comatose or simply unaware of their surroundings. I got the feeling they liked having someone who was alert and maybe even funny for a change. Before I knew it they were kidding around, too. Some of the humor got a bit bawdy, but somehow that seemed appropriate under the circumstances. At that point I was glad I was 59, not 29.

Beat the Clock

After Big Brother Oxford decided to discharge me, they couldn't get rid of me fast enough. Honestly, I believe that if there had been an eject button on the side of my bed, they would have used it. Then someone actually thought it might be wise to check if this was indeed a sound idea medically. One of the things they then realized was that my blood count was low. So low, in fact, that I resembled a Robert Pattinson victim with two holes in my neck (betcha didn't think I knew who Robert Pattinson was, did ya?!). The hemoglobin count in a healthy adult male is usually about 13-14; mine was 8 point something. That's considered really low. So after the decision was made to discharge me, the decision was made to transfuse me. I guess they figured that it wouldn't be good for Columbia Presbyterian's reputation as a world class medical facility if one of their freshly-released patients was found lying face-down on the sidewalk after having passed out due to a lack of red blood cells. They decided to give me two units (pints) of blood, and they hung the first one at about 3:15. Transfusing takes between two and three hours per unit, L-rd only knows why. The ambulance coming to get me was scheduled to arrive at around 7:00. Do the math. Kalman was visiting that day and he was just about to leave when this whole discharge thing came up, so he decided to stay; he figured he could ride in the ambulance with me. They were so gung-ho on my not missing the ambulance, they kept coming in and checking the flow of the blood in the IV, giving the bag a good squeeze every once in a while. I'm not making this up. I thought they were going to take the damn bag off the pole, put it in a doggy-bag and give it to me to go. About half-way through the second unit we got word that the bus (hospital jargon for "ambulance") was on its way. Kalman hung around, dutifully waiting. Somehow they got the red stuff to move just quickly enough so that it was all inside me in time. Incidently, I don't know who the donor was, but I think it might have been black guy, because, inexplicably, I can now dance. If I ever start developing a taste for rap music (an oxymoron if there ever was one), I'll just stick my head in the oven. Anyway, the ambulance showed up shortly thereafter. Just one little hitch: they were supposed to send one that was geared to handle a patient who was oxygen dependent, which this one was not. Even though I pleaded with the EMT's, they said they couldn't take me, they could lose their jobs, yada, yada, yada. So we were back to the proverbial drawing board. The ETA for the new, improved ambulance was 10:00. Kalman was at the hospital pretty much all day and he was exhausted, so he went home. The ambulance showed up at 9:00. Free at last! Free at last! Thank G-d A-mighty, I'm free at last!!

You're Outta Here!

My second stay in a regular room was fairly uneventful. There were times that I wondered why they were keeping me in the hospital. True, I couldn't really move very well, but I thought that was going to be fixed once I got to rehab. They sent in physical therapists pretty much every day. The stuff they asked me to do in bed (raise my legs, bend my knees, do armcurls with a Poland Spring bottle) I managed just fine. It was the stuff out of bed that was a problem. I couldn't stand on my own. That, of course, would preclude walking as well. It's truly amazing to what extent your muscles abandon you when you haven't used them for a while. Anyway, other than the occasional PT, an x-ray here, a cat scan there, my days consisted of eating, bedpan breaks and napping. Kinda like being an infant, only without the breastfeeding. Oh, and TV...lots of TV. Did you know that commercials on daytime TV are very different than they are during prime time? After a few days I started noticing the pattern: malpractice and/or personal injury lawyers, durable medical equipment (e.g. concentrators, inhalers, diabetes supplies) and retirement villages. So I started thinking, gee, who's their target demographic? Then it hit me...you are, dummy! Anyway, just as I was getting comfortable with the idea of room 614 in the Milstein Pavillion being my permanent home, they had the unmitigated chutzpah to discharge me. Actually "discharge" doesn't quite describe it accurately; "kick me out" is closer. One minute I was lying comfortably in bed watching "Big Cat Diaries", next minute they were sending in a social worker with discharge papers. It was as if there was a big Oxford Parking Meter somewhere and I had just run out of quarters. "Yeah, but..." I protested, "I can't walk". I guess that minor detail was lost on them. Apparently when Oxford says you're well enough to leave, you're out on your sponge-bathed butt.

Escape From The ICU! (part two)

This time I wasn't in the ICU very long. I think it was only a few days. Of course I had no idea that I would be out of there so quickly, so I was depressed and disheartened and disgusted and lots of other words that started with "D". Dr. Ramos, the shrink, came in to see me a few times. After the third or fourth visit he threw himself off the GW Bridge.* It was between that and swallowing Drano, but being a health care professional he knew that the lye would be very painful and wouldn't taste very good, even on the rocks with a twist. And it might even have caused a panic among both the nurses and the maintainance staff if it got really messy, like if his colon wound up in pieces on the floor of the staff lounge. I spent a lot of time watching TV. "Pet Star" on Animal Planet was a particular favorite; people brought their trained dogs or pot-bellied Vietnamese pigs or snails (honest, a kid actually brought a snail!) and had them do mostly ridiculous tricks, trying to win 2500 bucks. I loved the stupidity of the show until some skinny girl showed up with Einstein, the African Grey parrot. All African Greys look almost exactly alike, so it was like watching Oscar. Right then I wanted to follow Dr. Ramos with a swan-dive off the bridge of my own. There was one particular commercial that depressed me, too. These young, buff looking guys are on the beach challenging each other to a game of volleyball. It was a commercial for Coolatta, a drink at Dunkin' Donuts. Boy, did it look yummy. Every time I saw that damn commercial it made me realize that there was a chance that I was never going to be able to do everyday things again, like go to a Dunkin' Donuts or play volleyball or go to the mikva. Actually, I didn't really care too much about the last two, but if I couldn't ever eat another egg and cheese on a croissant, I would be really upset. Just as I was really getting into the depression and feeling really sorry for myself, they kicked me out again and sent me to yet another private room. Was it gonna stick this time? Did being in a real room mean that I was one step closer to getting discharged? Did Luke really rape Laura in the disco? Tune in next time for the next exciting episode of "Rocky Zweig, Medical Marvel".
* Relax, Dr. Ramos didn't really kill himself, I made it up. Had you there for a minute, didn't I?

Feest Time!

Remember the Feest Test that I refused to have ("Gag Order, August 15th.)? That's where they stick a endoscopy camera down your gullet and see if you can swallow solid foods and liquids without choking yourself to death. I had opted out originally and they found a non-invasive way to do it by x-raying me while I was swallowing. Well, now that I was back in the ICU, they decided I had to prove once again that I could eat safely. This time, however, they informed me that if I didn't agree to the Feest (Flexible Endoscopic Evaluation of Swallowing with Sensory Testing) Test it would take a while to do it the other way...maybe a week! Chayie and Kalman were there for moral support this time and somehow they talked (read: shamed) me into it. My anxiety about gagging notwithstanding, I said I'd try it. The girl (okay, woman, but she was sooooo cute) who wheeled the machine in was so nice and so friendly and so utterly smiley that I couldn't help being nice back. I think my sense of humor might have had a bit of an edge right then, just because I was trying to hide my apprehension. She went with it; I'm sure she'd worked with other crazy patients before. I made my little "I have an overactive gag reflex" speech and she was sweet and reassuring. Then her assistant, a guy named Guy (did you remember that, Chayie and Kalman?) drew the curtain, shut the lights in the room and turned on the monitor. I don't remember this but I'm sure she must have sprayed something down my throat to numb it a bit. Then she stuck the endoscope way down until it reached my larynx. I gagged one little gag, but then I was alright; I had conquered my Gagophobia! I was able to watch my swallowing mechanism right on the monitor and it was really quite cool. The pictures above on the right give you an idea what a larynx looks like through the lens of an endoscope. They gave me green apple sauce (the food coloring is so that they can see it on the screen as it goes down) and green crackers and green water and green milk. I swallowed them (very carefully I might add...I had had enough of feeding tubes!) like a champ without a hitch. Visions of mushrooms danced in my head. I was going to eat again!

Is Anybody Out There?

I keep wondering if anyone
actually reads this stuff.
My first post back on
July 12th drew twenty comments...twenty! Lately if I get one it's a lot. Most of the time I get none at all. Not that it matters all that much; I've gotten into writing it just for the sake of writing it, if you know what I mean. It's a way for me to expend some creative energy. It gives me the opportunity to do something constructive with my spare time, and that's pretty much the only kind of time I have these days. Also, the shrinks would call it theraputic or cathartic or some such psychobabble. So I'm asking all of you (hello?) to comment on this post, so I can have a kind of cyber-head count. You too, Yudi!

Hello Darkness, My Old Friend

The best part about leaving the ICU had been that I was never again going to be on a ventilator. Ever. I grew up watching Lee Majors as "The Six Million Dollar Man". A new word had entered the American lexicon: bionic. Part man, part machine. Then years later came the movie "Robocop", with the same basic theme; it romanticized being partially nuts and bolts and thereby becoming something less than human. For me being on the vent felt like that. I wasn't able to perform that most basic function of life, breathing, without the assistance of that mechanical monstrosity at my bedside. Now here I was back in the ICU, albeit in a room with a better view of my surroundings, being hooked back up to my old, inanimate nemesis. Yes, I knew it had saved my life, but I hated it anyway. I have a habit of naming everyday things; my toaster is Alvin, my umbrella, Shaniqua (it's a black umbrella). I refused to name my vent...that's how much I hated it. It was one of the darkest moments of my journey. Being transferred to a regular room had convinced me that perhaps I was actually on the mend. Then it was all yanked away from me and I was back where I started. I was devastated. Thank G-d my new relationship with my mechanical breathing partner was short-lived: they only kept me on the vent for a few hours this time, just until I stabilized. Then at night Dr. Yip wanted me to go back on it, just to be safe. I vetoed that possibility. I pleaded with her to let me sleep in peace, let me try to be a mentch. She finally acquiesced. I swore to myself: never again. I asked Chayie, my health care proxy, to promise me that she would never consent to having me put back on a vent, no matter the circumstances. She informed me that that was a promise she could not make. See what happens when you give a woman a little power?

Russell

I am writing this post out of order because I think it's important. This is about something that happened today, August 22nd. My brother-in-law Dave came home from shul and told me that there was a "big bird" sitting in the middle of the street, obviously injured. Someone had put up a traffic cone nearby to alert drivers. Now, why he told me this, I haven't the foggiest notion. Knowing me as long as he does, he had to know that there was no way I was going let an injured bird get hit by a car if I could help it. I went out to look. The big bird was not what you'd find on Sesame Street...it was a crow.
I approached him as gently as I could and he was very sweet. He let me stroke his head and his back. From up close crows are quite beautiful. They seem to be solid black from a distance but their plumage is actually iridescent, with subtle shades of blue and purple. I brought him into the house and called a few wildlife rehabilitation places. The only one that I found that was open was waaaaaaay out in the boonies in New Jersey. I put Russell (oh, I forgot to tell you; his name was Russell and that's him in the photo) in a box and was ready to leave when Chayie appeared at the top of the stairs. I told her I had a bird down in the basement. Remember how I told you I had ringing in my ears? I think the shriek she let out blew any chance of my tinnitus ever being resolved. She screamed as if I was one of her kids. I guess she's entitled: she's been doing my laundry and cooking my food for four months. I snuck out the side door, cranked up the GPS and headed out to the Raptor Trust in Millington, NJ. They were happy to accept Russell and said they'd do everything they could for him; young crows, they informed me, are very susceptible to West Nile Virus that they contract by being bitten by an infected mosquito. I left there feeling good about myself. I felt I had done a mitzvah (good deed). When I got back I asked Chayie what she was all bent out of shape about. She said that I should bear in mind that I was not the only one who had gone through hell because of my illness. She had, too. As had my brother and my kids and my mom and anyone else who cared about me, to one extent or another. She said that I'm busy with my blog and I've personalized my journey and I've forgotten that it touched and affected many other lives. Because of the possibility that my birds were a mitigating factor in my winding up in extremely critical condition, she felt that by handling a bird, any bird, under any circumstances and even just for a few minutes for totally altruistic reasons, I was being completely irresponsible. Worse, my behavior was an insult to everyone who worried about me and came to visit me and sat with me and prayed for me. I'm writing this post to go one record as saying that I'm not sure I agree with any of that, but I love my sister and I understand and respect how she feels. And if another injured bird comes along, I'll do exactly the same thing.

PS It is now Tuesday, August 24th, two days later. I just called the Raptor Trust to see how Russell was doing and they told me that he had died. He had some kind of central nervous system problem and when he took food he gurgled a little so he probably had an obstruction of some kind as well. The woman I spoke to, Laura, thanked me a few times for bringing him in, all the way from Brooklyn. So I accomplished two things:
1. Although Russell went to birdy heaven, he didn't get there by being hit by a Mack Truck.
2. My bringing him out there turned out to be a nice little kiddush hashem.

Bump in the Road #1

I had been told that the worst pulmonologist at Columbia Presbyterian was better than the best one at Beth Israel (see post #25). That's why I never quite figured out how what happened next could happen. Gradually my temperature began rising (had nothing to do with the room's thermostat) and my sats began falling. One would think that those are two definite red flags, right? Only Dr. Preger missed 'em. Relapses during the treatment of C.O.P. are not uncommon; indeed, they're almost expected. I was having my first and it almost went unnoticed. Thank goodness for Dr. Jonny Kim. Dr. Kim, a young P.I.T. (pulmonologist-in-training) was the one who made the decision to send me back to the ICU. Not that I was thrilled to go, mind you. It had taken me a few weeks to get out of there, and in my mind going back was tantamount to conceding defeat. But they didn't really give me a choice. In retrospect, it was, of course, the right thing to do. But at the time the somewhat unrealistic elation I had been feeling since leaving the ICU came crashing down around my head, and my depression returned with a vengeance; was I ever going home?

Naked Day at Columbia (guaranteed at least 97% true!)

Things were rolling along swimmingly in my private room. Dr.Preger, one of about 150 pulmonologists ostensibly contributing to my care (and then billing Oxford...I'm sure they were thrilled), was so pleased with my progress that he wanted to take out the trach. That scared me a little; I hadn't tried to breathe on my own in weeks. One of the nurses decided to give me ativan (a fast acting anti-anxiety medication, similar to valium). I don't know how much she gave me, but my guess is it must have been a lot. I don't remember any of what follows; the details were culled from a conversation with someone who was there. Anyway, apparently there was something wrong with the thermostat in my room, and the temperature kept climbing. According to the eyewitness, the ativan had thrown me into something similar to a "drunken stupor". In my delirium I must have thought I was in the Mojave at noon. All I was wearing was my hospital gown. I proceeded to kick off my covers and take off the gown. The nurse put it back on, admonishing me to behave. I took it off again. She called for back-up. Soon there was a fairly good sized audience for the show: nurses and doctors circling the bed, four visitors who shall remain nameless, and the maintainance guys working on the thermostat. They finally just balled the gown up so that it covered what they most wanted to be covered. I don't have too many details beyond that. By conjecture I assume the thermostat got fixed eventually. I also found several of the nurses' phone numbers tucked neatly under my pillow.

Will Somebody Please Answer That *#$&*@ Phone?!

Tinnitus. Even the name is annoying. That's the scientific name for ringing in the ears. We've all experienced it briefly one time or another. A loud boom, a marital spat whose decibel level rises to challenge that of a jackhammer...these things set off that alarm in your head where your ears are telling you, "Hey! Would you knock it off already? We're tryin' to work here!" I've read online that it can be loud enough to drive you totally bonkers Mine isn't that bad, thank G-d. In fact, I only have it in one ear (the right one). As usual, none of the doctors seemed to care or even listen when I mentioned it. I know, I know; they were concentrating on more important things...like keeping me breathing. Still, tinnitus is not fun. When I googled it, I discovered that there's a whole slew (as opposed to half a slew) of antibiotics that can cause it, not the least of which is our old friend Vancomycin. Also Bactrim and Dapsone, both of which I've been on. I asked Dr. Katzenelenbogen about it recently and he said there's no cure for tinnitus. So I went to the Brooklyn College Audiology Department for a (free!) hearing test and evaluation. My hearing is okay for my age, and there's no cure for tinnitus. So I went to Dr. Ana Kim at New York Eye and Ear Infirmary who looked in my ear and told me there's no cure for tinnitus, that'll be $50.00, please. Am I beginning to sense a pattern here? I told Dr. Kim that I'm taking this heeby-jeeby stuff called Lipo-Flavonoid that purportedly helps. Her response? "Couldn't hoit!" Okay, those weren't her exact words; she is Chinese, after all. She said after it becomes clear that the Lipo-Flavonoid isn't doing jack, I should try niacin. When that doesn't work I should try ginko biloba. When that doesn't work I should jump up and down ten times and yell "yippee". Okay, I made that last one up. The good news is that whatever hearing loss I have will not get worse and that the tinnitus will probably clear up on its own eventually. She didn't say how long it would take, so I suppose I'll have to stay alive at least until the ringing goes away, if only to maintain Dr. Kim's reputation. As good a reason as any, I guess.

Shake, Rattle & Roll

I have a cousin who must be in her 70's by now. I noticed quite a while ago that her hands shake quite badly. I always wondered if she had Parkinson's (or, as my mother-in-law a"h used to call it, "Parking Disease"). I also felt sorry for her; she was a relatively young woman. Then about a year ago I noticed my own hands shaking. It was slight and it didn't really interfere with anything, so I didn't really pay too much attention. Well, since I came out of sedation, the shaking has gotten a lot worse. There are times when I can hardly write. My neurologist (I have soooo many different "ologists"!) decided that it's something called Benign Essential Tremor. My primary care physician is not so sure. He thinks it might have something to do with the myriad medications I'm taking. It comes and goes and seems to be worse when I'm stressed. Benign Essential Tremor can be treated medically but, ironically, a lot of the medications used are contraindicated for people with breathing problems. Wouldn't you know it? My neurologist told me off the record that alcohol helps, and he didn't mean rubbing alcohol. A bottle of beer, a glass of wine, or a shot of hard liquor. My choice. Almost worth the tremors, wouldn't you say? I've tried it and it might have worked; I don't remember because I woke up under the table in Richie's Clam Bar in Bayonne, drooling on a guy named Nunzio who woke me from my peaceful slumber with his infernal snoring.

Shuffle Off to Buffalo

Ever hear of drop foot? Or is it foot drop? Here's what happens: normally when you walk, your foot is parallel to the ground. When you have drop foot, your foot flops down and points to the ground. I think it can be caused by a number of factors, but the way it's been explained to me is that by sitting or sleeping in one position too long, the sciatic nerve can be compressed, thereby causing the foot to drop. Hey, it didn't make much sense to me, either. About 10 years ago I fell asleep with my legs crossed and woke up with drop foot in my right foot. When I walked I had to consciously raise my foot higher than I normally would, otherwise it would flop down and I would trip. This bizarre gait was awkward, to be sure, but it kept me from finding myself face down on the pavement. Ultimately it resolved on its own. Anyway, because of my previous episode, when I awoke from sedation and found my foot flopping down (the left one this time) I knew exactly what it was. I wasn't happy about it but at least I knew it wasn't anything life-threatening. What I found more troubling was the numbness that ran from my knee all the way down through my toes. Inexplicably there was slight numbness in my right leg as well. Also, the fact that none of the health care professionals around me were the least bit concerned about it was quite irritating. Apparently when they're busy saving your life they don't pay attention to the little niggling details like walking and stuff. I can now report that the drop foot itself has pretty much cleared up on its own; I'd say it's about 80% there. I can walk pretty well, although every once in a while I'll find the foot dragging slightly, just enough to cause it to catch momentarily on a crack in the sidewalk. The numbness hasn't gotten any better, so my legs feel like they're weighted down. That makes walking for any prolonged period of time quite difficult. I wind up short of breath and ironically I believe the problem is in my legs, not my lungs.
PS I'm not sure if I look like Stepin Fetchit when I walk, but I sure feel like him sometimes. Never heard of Stepin Fetchit? He was a black guy who was a bonafide Hollywood star who was famous for jus' shufflin' along. He was the first black actor to be allowed in the front gate of MGM. In a chauffered limo, no less. Unfortunately, the only perk my own shuffle offers is tripping and cracking my head open. I think I'll pass.

Escape From The ICU! (part one)

Against all odds, I actually started making progress. They had identified the bug that had almost cost me my life and were treating me accordingly. Every day the doctors on rounds assured me I was improving. Every day, I didn't believe them. I didn't feel any better. I still could barely move. I still had ringing in my ears. I still had "drop foot". I still had tremors (more about those last three later). I think my profound depression precluded me from seeing any light at the end of the proverbial tunnel. And then one day it happened: they told me I was being transferred to a regular room. OH MY G-D! You mean I actually won't die in this G-d forsaken ICU?? Then sure enough there I was, in a room. A private room, no less (apparently having MRSA does have a perk or two). I had a bed and a TV and a call bell...what could be bad? The most amazing thing for me was that there had actually been movement. Now I could no longer question the veracity of the optimistic doctors who had started to tell my family and me that in all likelihood, I would survive. At the beginning they were hedging their bets, but now they were willing to go out on a limb and actually predict that I would (eventually) recover. I wasn't sure I believed it, but it did present a modicum of hope. While being in a real room didn't afford me the kind of attention that I had gotten in the ICU, I gladly took the trade-off. I was starting to feel almost human again. Almost.

The Sound of Silence, part two

What the doctors hadn't told me was that if I simply put my finger over the cannula (the tube that was inserted in the trach that was inserted in the hole in my neck), I would be able to speak. I had no idea. I think they didn't want me talking in the beginning because they were concerned about how it might affect my breathing. So I lay there as mute as a monk for days. The more awake and aware I became, the more my inability to communicate exacerbated my depression. It didn't help that none of the doctors or nurses were particularly adept at reading lips. "I'm hungry," I'd mouth. They'd repeat: "You're ugly?" "I'm hungry!" "You're angry?" And so it went until I was ready to throw a chair at them, had I had the strength. I eventually figured out how to use the text feature on my phone to bitch about stuff, but that was later. When they thought that my breathing was improving, they promised me a Passy-Muir valve (see picture above). It fits onto the aforementioned cannula and allows the patient to talk. The mechanism reminded me of a kazoo; there was a thin membrane that vibrated when you spoke and volia...sound! So I kvetched and kvetched and finally got the damn thing and unleashed a veritable torrent of (very impressive, I might add) vernacular and verbiage. It didn't need to make sense; "Embargo!" I'd cry, apropos of nothing. "Liederhosen!" "Cumquat!" Then I figured I better shut up before they sent the shrinks back in.

The Sound of Silence, part one

left to right: Brad Pitt, Edward Norton

When I woke up, I couldn't speak. Perhaps because I was still woozy from the sedation, it didn't occur to me at first to question why I couldn't speak. Believe it or not, I also couldn't tell time, use a cell phone or write. To this day I believe that at some point when I was out, there was some oxygen deprivation to my brain. Someone (I still don't know who) had taken a yellow legal pad and written all the letters of the alphabet on it for me to point to so I could spell words and communicate. One night during the second week of my journey from coma to consciousness I was actually able to watch TV. Unfortunately my choice of entertainment was somewhat unnerving; I watched a very bizarre movie called "Fight Club". There's a character in it named Tyler Durden, who doesn't really exist. He is merely the alter ego of the protagonist, whose name escapes me. In fact, he may not even have had a name. I was half zonked when I watched this, so as little sense as the stupid flick would have made to a fully-conscious human being, it made even less to me. Next day Kalman and Blimie were there and I was pretty sure that Kalman had either read the book or seen the movie. I wanted to ask him about it, so he whipped out the alphabet pad. I pointed to "F". He and Blimie repeated: "Eff". Then I pointed to "I". Then "G". "Fig!" they shouted in unison..."Dad wants a fig!" It was time to get my voice back.

Food, Glorious Food!

Remember I told you that I told the "Feest Test" guys to take a hike? That would have determined if they could start me on real food instead of the gruel they were shoving up my nose. Well, they knew at some point they were going to have to give me something to eat. So a few days later they wheeled me down into an x-ray room and did the test another way: they had me stand in front of the x-ray machine and swallow stuff. It was actually quite cool. I was able to watch the screen out of the corner of my eye and could actually see myself swallowing. I decided that I have a very attractive skull. I'm not sure if this testing method was improvised just for a stubborn ox like me, or if had already been established for previous stubborn oxen who had found their way to Columbia Presbyterian over the years. Anyway, when they were convinced that I wasn't going to choke on my food, they yanked out the feeding tube and I was ready to dine at the Waldorf. There were a few problems, though. First of all...Question: what do Presbyterians know about kosher food? Answer: absolutely nothing! I got the usual double-wrapped stuff that you see in such institutions and on planes, but somehow it was even worse than usual. Chicken with mushrooms. Meatloaf with mushrooms. Rice Krispies with mushrooms. Didn't they know that I was just beginning to recover from a life-threatening illness? Why were they feeding me fungi?? Second problem: I was too weak to hold a spoon, to open a container of milk, to unwrap a meal. Also, the food-bringer (don't know what else to call them) usually didn't realize that I could barely move, so they'd leave the tray just out of my reach. How frustrating is that?! If one of my kids wasn't around, I didn't eat the stuff until I could get someone's attention and they'd eventually come in and help me. By that time my tilapia was as cold as the vast Atlantic from whence it came and its mushrooms were as coagulated as a blood clot. There were moments in the ICU when a small glimmer of optimism would creep into my attitude and I'd think that maybe, just maybe, I wouldn't leave the ICU in a body bag after all. Then they'd bring me my meal and I realized that even if they cured me, I'd never survive the food.

My Amazing Kids

Yeah, I know...they don't look like that anymore. But it's my favorite picture of them. Left to right it's Kalman (Michael), Feige (Robyn) and Blimie (Bonnie). They were young and innocent and figured their dad would be around forever. Sadly, that innocence has dissipated somewhat over the years. Mine, too, although I think I've been pretty successful at clinging to my inner child. Maybe too successful. Sometimes my inner child becomes my outer child. Like when I buy more birds when the first one is turning my lungs to guacamole. Anyway, getting back to my kids. Since I have no intention of changing my marital status between now and when I finally do meet my demise, I figured that at some point, maybe in 20 or even 30 years from now, my kids would have to take care of me. But not at age fifty-nine! If the way they responded to my near-death experience is any indication of what I can expect in my dotage, I have nothing to worry about. They were magnificent. When children go through a divorce, they're always affected. Frenchi (ex-wife #1, mother of the kids) and I did our best not to triagulate them in the process of divorce, but it's unrealistic to think there wasn't any fallout. I was secure in the knowledge that my kids love me. I also knew that they might be angry at me (okay, I knew they were angry at me). But they really proved their mettle when the chips were down. They tooks shifts when I was sedated so that one of them was there with me 24/7. If I'm not mistaken there was not one day while I was in the ICU that one of them didn't show up. When I woke up I was so weak I could barely budge. The kids were there for me no matter what I needed. They encouraged me, made me laugh and made sure I was getting the best care possible. I'm pretty sure they're not reading this, but I want them to know how very much I love them, but more importantly, how incredibly proud I am of them.

Superbug

They say that a hospital is no place for sick people. When you're sick your resistance tends to be somewhat compromised and consequently you are prone to picking up all sorts of nasty little bugs that are floating around. You can get them from the hands of a nurse that weren't properly washed, a piece of fish that wasn't properly cooked, or by French kissing your new roommate; you know, the one with meningitis (more about that later). One of the souvenirs I picked up at Columbia Presbyterian (not available at the lobby gift shop) is called MRSA, which stands for Methicillin Resistant Staphylococcus Aureus. They call it that because it is a staph infection that is resistant to methicillin. Doctors are very logical that way. It is, in my humble opinion, also resistant to any other, more novel means of eradicating it. Like taking a blowtorch to your lungs. What they actually wind up giving you is massive doses of an antibiotic called Vancomycin, also known as The Antibiotic of Last Resort. No kidding; that's what they call it. So naturally, they put me on Vancomycin. It's very expensive and comes with a bonus of lots of fun side effects, not the least of which is ringing in the ears, a.k.a. tinnitus. That's what it gave me (more on that later). Another thing I managed to contract in Columbia Presbyterian was Clostridum Difficile, a.k.a. C-Diff. It is caused by antibiotics that are given to fight the toxic bacteria in your body but also kill the good bacteria that live peacefully in your colon. I wasn't symptomatic until I got to Silver Lake (more on Silver Lake later, too). C-Diff can give you a lot of awful symptoms, but what it gave me was absolutely wicked diarrhea. I won't go into too many details but suffice it to say, it wasn't pretty (right, Surele?). So guess how they treat C-Diff? Vancomycin! Did someone say "ringing in the ears"?
PS There's been a lot of talk in the news lately about superbugs in general and one in particular that is originated in India. If you're interested,
here's a link: http://www.reuters.com/article/idUSTRE67A0YU20100811

Gag Order

I've always felt that I have an overactive gag reflex. I gag when I brush my teeth. Is that normal? I had an endoscopy several years back. They put me out and things went swimmingly. Then I had another one. This time they just numbed my throat with some spray or something, insisting that it would be okay. It wasn't. I gagged throughout the procedure. Maybe it's psychological, but since then every time someone tries to shove something up my nose or down my throat I tense up and the whole sorry mess becomes a self-fulfilling prophesy. So here I was, lying helpless in the ICU, with a feeding tube up my nose. Upon awakening from the sedation, I must have felt uncomfortable with that foreign object snaking its way down to my stomach, because I groggily yanked it out. I was still half in a stupor; I didn't even know what it was. Several doctors tried getting that sucker back down where it belonged, to no avail. So guess who they turned to? Bingo! Good ol' Bob. The guy knew what he was doing but also knew me; he knew how to talk to me, how to calm me down, how to get me to acquiece and agree to things to which I had no intention of agreeing. After a while they were thinking about giving me solid foods and they wanted to administer a test appropriately called "Feest" (Flexible Endoscopic Evaluation of Swallowing with Sensory Testing). They wheeled in this really nasty looking aparatus that included a scope that was as wide as my Johnny Cash finger (private joke) and longer than the Crimean War (private joke that even I don't understand). I very nastily informed them to get that contraption the hell out of my room. I may have even used my Johnny Cash finger. They left, never to return. That meant that I couldn't get real food and that I was stuck with that damn tube up my nose. Brilliant, dontcha think?

Bob



Yes! It's really him!

Okay, Bob didn't really give me mouth to mouth. But he did just about anything else he possibly could to keep me reasonably comfortable and sane. Bob was a male nurse, although I think the gender distinction has been dropped nowadays. He was a Hispanic guy (or maybe Asian, I was never sure). I have a feeling Bob was not his real name. Of all the nurses I've had taking care of me over the last six months or so, he was the most competent and the most compassionate. That's a pretty great combination, don't you think? There were things he did for me that he wasn't supposed to, things that could have gotten him into trouble. He recognized that a human being who has been reduced to a helpless shell of his former self has special needs just to keep some semblance of dignity. For example: that fateful first day that I was in Columbia Presbyterian, I needed to go to the bathroom. I had never used a bedpan before. I also still didn't realize how sick I was and what was coming up. When I called Bob over and told him I had to go, he brought me a bedpan. I wasn't my usual obnoxious self with Bob, but I informed him that I'd really prefer to do to it the old fashioned way. He tried to talk me out of it, but finally realized that it wasn't about going to the bathroom. It was about a 59 year old man desperately clinging to the last vestiges of his humanity before he evolved into something else: a patient. There was a really cute toilet my ICU room that folded out from under the sink and then folded back neatly and out of sight. With the doctors outside the room waiting to come in and put me on the ventilator, Bob pulled the curtains, helped me up and out of bed, left me alone so I could have some privacy and came back and helped me back into bed. When the doctors came in, the head guy (whose name escapes me) was none too happy with Bob. He thought it was wholly inappropriate for me to be using a toilet rather than a bedpan in my condition. Personally I think he was just pissed that he had to stand outside the room for an extra minute or two. There were other things over the next few weeks, some of them embarrassing, that Bob handled for me with grace and aplomb. There were enemas to perform and feeding tubes to replace and my world famous temper to, um, to temper. Bob was always there for me, being so nice I couldn't be upset with him just because he was doing something I didn't like or telling me something I didn't want to hear. He was exceptionally accessible and forthcoming with my kids and my siblings and they all loved him. I've met dozens and dozens health care professionals over the past few months. No one even came close: Bob was my rock.

GET ME MY PANTS!

So a few posts ago I talked about my state of mind upon awakening from my little beauty nap. I had no clue as to what had been going on around me for the prior two weeks, no idea whatsoever how close I had come to buying the farm. Kicking the bucket. Pushing up those ol' daisies. I had just turned 59, for crying out loud. Death was not something I worried about; I figured I had another twenty good years, at least. Who knows, maybe even thirty. Of course that "who knows" reveals the fallacy of that attitude. Who knows, indeed. Could be thirty years, could be tomorrow. I've learned that lesson now, the hard way of course, but before I got sick I was just cruising through life, like a lot of us tend to do, not paying attention, not stopping to smell the proverbial flowers. I'm pretty sure that was a run-on sentence, but that's okay because it's already been established that no one is reading this thing anymore. But I digress. I'll get to the G-d stuff, all the spiritual, existential issues that these last few months have given rise to in a future post. This was supposed to be about how dazed and confused I was when I came to. Sitting up in bed for the first time in two weeks, all I really knew was that I had had enough of hospitals. I wanted out! So my old obnoxious personna asserted itself and I literally said, "get me my pants, I'm going home." Only problem was, I couldn't talk because of the trach. Incredibly, I didn't even stop to ask someone, anyone, "hey, how come when I speak, no sound comes out". Not right away, anyway. So I had Chayie call every doctor I had ever known to try and pull some strings and get me discharged. She called my primary care physician, my neurologist, my urologist, even my shrink. Yeah, I know, you'd never believe that I'd go to a shrink, right? Chayie played the dutiful sister perfectly, calling everyone I asked her to, even though she knew it was an excersize in futility. I finally pulled out that old chestnut: "I wanna be discharged A.M.A. (against medical advice)". Unbeknowst to me at the time, I was literally too weak to move. Did you know that when you don't use your muscles for a week, they completely desert you? No wonder everyone was ignoring my angry, silent outbursts...they knew that there was no way I could pull it off. Finally my son-in-law Yehuda told me okay, he'd bring my pants if I could demonstrate to him that I could even move my legs. Couldn't do it. I think I shut up after that. Good thing, too, since I sounded like Marcel Marceau.

Questionable Chronology

I don't know if you've noticed, but the chronology I have laid out in some of the posts is somewhat skewered. I seem to be jumping back and forth quite a lot. This is true.
It is mainly because my recollection of the time I spent at Columbia Presbyterian (I'm soooooo proud that I know how to spell Presbyterian!) is a little fuzzy, and the first week or two are even fuzzier. So I'm relying a lot on what other people are telling me (Chayie and Blimie, mostly) and by the time I figure out what happened when, I've already posted it out of order. Does that make sense? Do you care? Of course you don't. Know how I know you don't? Because you're not even out there; no one is reading this farkakteh blog! It's okay, I'm not insulted. I'm doing this for myself. It gives me something to do when Judge Judy's not on. It's theraputic. It's cathartic. It's...okay, maybe I'm a little insulted. Know how I know no one reads it? Because no one comments on it! I think I should write something totally outrageous and see if anyone comments on it. Hmmmm...okay, here's a riddle (apropos of nothing): why did the chicken cross East 12th Street? First person who posts a comment with the correct answer gets a prize. Something personal that has special sentimental value to me, a tangible reminder of my journey through the wonderful world of health care. One of my old urinals, perhaps. Or a trach cannula that still holds a trace of sputum. Or maybe...yeah, that's it! An 8x10 glossy of the almost world famous picture of my Guinness-Book-of-Records sized Hemotoma (photo by Yehuda Lieberman). Definitely suitable for framing. Honestly, I do believe that will be worth a pretty penny someday. Okay, now prove me wrong: I want comments!

Waking Up Is Hard To Do

From the time I was put on the vent (apparently the terms "respirator" and "ventilator" are used interchangeably) until I was taken off was about a week. At that point it was determined that I was still unable to breathe on my own, so they waited for an operating room and performed two procedures: they did a tracheostomy and a lung biopsy. Around Thursday of that week I developed an infection in my colon. That was my first major setback. This was the week that my kids and siblings were waiting for me to wake up, but with all the antibiotics on top of the leftover grogginess from the sedation, that wasn't going to happen. My kids, I understand, were quite distraught. I don't know if they articulated it, but apparently there was a fear that I was never waking up. Finally, the following Tuesday, two weeks to the day from the time I was admitted, I was fully awake and actually sitting up in bed. That was when Blimie hugged me (see earlier post, "nisht ahin, nisht aherr"). She wasn't there when I came to, but Chayie called her to tell her. She couldn't believe it. Is he really, really up and being himself, she wanted to know. Yes, Chayie said, he's even being nasty. That's when she knew that I had returned to the land of the living with a vengeance, and she came running. The most bizarre part of my coming to, according to Chayie, was that I didn't seem to mind or even notice that because of the thrach, I couldn't talk. Chayie says it was as if I had woken up from a nap. I had no idea how long I was out and no idea how sick I was. In my drug-addled mind I was ready to be discharged.

Eenie Meenie Mynie Moe...

When I first came to Columbia Presbyterian (hereafter referred to as "Columbia Presbyterian") the doctors and nurses acted sort of like Beth Israel on amphetamines: they had no idea what was wrong with me, but at least they were hurrying and running and bustling around trying to figure it out. First order of business was getting me on the respirator. After that they tried to determine what exactly their diagnosis would be. As I understand it, the way that was done was by hanging about twenty different kinds of antibiotics on the IV pole and then waiting to see which one my wretched, tortured ol' lungs responded to. When I finally awoke there was some information lying next to my bed about a type of pneumonia called Bronchiolitis Obliterans with Organizing Pneumonia, or B.O.O.P. Apparently the doctors had finally figured out what disease I had and someone (I still don't know who) Googled it and left it for me to read. Personally I thought that it was very hard to take an illness named B.O.O.P. seriously. So, just for me they changed its name. Really! It is now officially called Cryptogenic Organizing Pneumonia, or C.O.P.. Come on now, if you were fighting a teensy little bacteria that was trying desparately to kill you, wouldn't you want it to have a name it could be proud of?

PS Here's a link to a website about C.O.P. or B.O.O.P., in case you're interested... http://www.cop-boop.org.uk/

The Great Depression

Picture this: you're cooped up in a hospital ICU room and you can't speak. You can't shower or go to the bathroom yourself. The highlight of your day, every day, is when the doctors come to see you on rounds. Every day you look forward to that visit as if those white-coated, fresh-faced young healers were the Messiah. You keep thinking, this is the day I get a straight answer. Every day around 11:00 you see them going around to each patient on the unit. Most of them are unconscious (the patients, not the doctors). Most of them are quite old. At least that's your perception; you can't really see too many from your vantage point. Finally around 12:00 they get to you. Dr. Natalie Yip, a nice, young, pregnant pulmonologist is leading rounds. The doctors come in and smile at you. Despite the fact that you can't really communicate effectively, you have somehow managed to ingratiate yourself to them; you can tell that they like you. You mouth the same question to Dr. Yip that you asked her yesterday, the same question you'll ask her again tomorrow: when can I go home?
Dr. Yip is nice, young, pregnant and patient, but she is not omnicient. She has no idea when you can go home. You suspect she's not even sure if you can go home. Ever. So she just smiles her sweet smile and tells you again, for the umpteenth time, that she doesn't know. Got the picture? How do you think you'd react to this emotionally brutal scenario? Well, I became profoundly depressed. There were times I wasn't sure I wanted to go on living under those circumstances. The only things that kept me going? My grandson Menachem was due to celebrate his Bar Mitzvah in a few months and my daughter Blimie had just had her first baby, a gorgeous little girl named Meira. I wanted to be at the Bar Mitzvah and meet my new granddaughter. Had it not been for those two goals, I would have thrown in the towel. It got so bad, they finally sicced the shrinks on me. First there was Dr. Ramos, a slight young man of indeterminate ethnicity: he looked asian but had a hispanic surname and no trace of an accent of any kind. Despite his small frame he was physically clumsy and walked with a rather awkward gait. He interviewed me (difficult to do with a patient who can't speak) and my answers must have been quite alarming, because the next day he brought along two of his colleagues, one of whom was the chairman of the psychiatry department. They wanted me to give them my word that I wasn't going to hurt myself. I knew that I wasn't, and I suspected that they did too, but I understood that they didn't want anything to happen to me by my own hand on their watch. I gave them my word, watched them leave, and tried to cry. I couldn't.

Hey...How 'bout a Nice Hole in the Neck?

No one asked me if I wanted a hole in my neck. I guess it could come in handy if you have a really nifty pendant and no chain to hang it on. Generally, though, I tend to shy away from having holes bored into pretty much any of my body parts. Protesting the procedure, however, would have been highly impractical as well as unwise. First of all, I was sedated at the time, and second of all, I couldn't breathe. So I came out of the OR with a tracheostomy. They stick this contraption halfway down your throat which holds a glorified tube called a cannula. The cannula is then connected to the oxygen source. It also allows the nurse unfettered access to the lungs when the patient needs mucus suctioned out which he cannot cough up by himself. This procedure is usually quite gag-filled (gag as in to gag, not gag as in practical joke), or at least for me it was (more about my gag reflex later). It's not a good idea to have a trach any longer than absolutely necessary because it provides a wonderful portal for new colonies of bacteria. But the worst part is that you can't talk. That really does put a giant crimp in one's ability to communicate; especially a shy, reticent type like me.

Stairway To Heaven

My father and I had a nice chat when I visited him. He's in a nice condo overlooking a lovely group of cumulus clouds, under which you can just make out greater Hoboken. My dad was happy to see me, of course, but sad, too. He thought I should have been allowed to stick around on earth for a while and see my grandchildren get married. I concurred completely. He took me over to Harry Chapin's place (the righteous goyim have their own neighborhood). When we got there Shlomo was there, jamming with Harry. I should have known! I got a big boruch haboh from Shlomo. He wanted to know how I had wound up there so early. I told him I didn't know, but it might have had something to do with my birds. He was confused by that, and rightfully so. So was I. I wanted to know if he had any clout with the Big Guy; maybe he could find out whether there might have been a mistake made, that it really wasn't my time yet. He said he'd make a call...he knew someone who knew someone. Anyway, then the lunch siren went off. We all went to the dining room (except Harry; the goyim have their own food court with, among others, a McDonald's, a Sbarro's and of course the ubiquitous Starbucks). The dining room was amazing. First of all, FYI: there was mixed seating! Dad and I grabbed seats next to Sam and Esther Lieberman. Across the room I saw Dave Engel chatting up Beverly Sills. Personally, I didn't see that shidach at all. It was a veritable Who's Who of dead Jews. I saw the Ramchal playing five card stud with Jack Benny, who claimed that the holy rabbi was cheating. Moshe Rabbeinu and his wife, Mrs. Rabbeinu, were very friendly and gracious; humble, too. Jonas Salk was debating a point with the Rambam. There were these winged waiters flitting about the room. You had a choice between beef lo mein and Amnon's pizza that day. I don't know; you'd think they'd serve something more...more heavenly, right? Apparently the Big Guy is a big fan of Amnon's. Who knew? Oh, and the beef lo mein desparately needed salt. It took me 15 minutes to flag down my waiter and another 10 minutes for him to bring some to the table. I decided I wasn't going to tip him, then I realized that I was wearing nothing but my hospital gown and it had no pockets, so it was kind of moot. Just then Shlomo came running up to me with the news: according to his sources, a mistake had indeed been made. The Malach HaMovess had seen me lying there like a flounder and had simply assumed and jumped the gun. Well, you know what happens when you assume, right? Dad and I said our goodbyes, I clicked my heels together three times and said "there's no place like Columbia Presbyterian" and I was on my way. My father sent regards to everyone, but I never delivered them.

Hey, who was gonna believe me?!

PS If you look closely at that picture of me at the top, you'll notice that my nostrils don't match. It's something I've wondered about for many years.

Nisht Ahin, Nisht Aherr

I'll bet you're wondering what the title of this post means, especially if you're not Jewish. I would imagine you're also puzzled about the bizarre looking creature to the left. Allow me to explain: "Nisht ahin, nisht aherr" is a Yiddish expression which roughly translates as "neither here nor there". However, there are synonyms in Yiddish, just as there are in any language. In Yiddish, the word "hin" means chicken. A "herr" is a rabbit. So, as a play on words, "nisht ahin, nisht aherr" can be translated as "not a chicken, not a rabbit". Got it? Good...there's gonna be a quiz later.
When I say "neither here nor there", however, I don't intend it to mean what it usually does when people say "that's neither here nor there". I don't even understand that expression. What I'm trying to convey is what it's like to be sedated and on a ventilator. You're not dead. But you certainly aren't particulalry alive, either. There were times that I was mildly aware of my surroundings. I know now, after the fact, that my kids and my siblings were there with me almost constantly. I know too that Chayie kept repeating, "when he wakes up, I'm gonna kill him" (a threat, incidently, that she is still thinking about making good on). There were times when my eyes would open briefly and someone in the room would try to talk to me. I think I remember Vrumi doing that. I definitely remember my cousin Duvy's face (hi, Duv!) hovering mere inches from mine telling me that although I was very sick, I was going to be okay. I remember my mother stroking my face. Truth be told, looking back all these months later, it all seems quite surreal. There was a huge disparity between my reaction and the reaction of people present when I finally woke up: my daughter Blimie hugged me and cried, cried as I hadn't seen her cry since she was a little girl. I was totally confused; what in the world was she so hysterical about? Of course I wasn't at all aware that Blimie had just spent the better part of a week looking at her father, who, during that period, seemed about as alive as a cabbage. Chayie would explain to me later that Blimie was convinced that I was never waking up. Oh, and my reaction? "Get me my pants, I'm going home!" Yeah, riiiiiiiight.

The Plot Sickens...

Remember how I told you that my recollection of what happened right before and right after things got really scary was somewhat murky? Well, that begins now. In fact, I had to ask Chayie exactly what happened next. So I now know that I checked into Beth Israel Saturday night, January 30th. I was there for just two days, Sunday and Monday, before the conclusion was reached that if I stayed there any longer, I would be leaving in a body bag. Their last ditch effort to keep me breathing was that contraption you see in the picture, the unwieldy, insanely uncomfortable C-PAP machine. C-PAP stands for "Continuous Positive Airway Pressure", which means exactly what it sounds like: it basically just pushes oxygen into your lungs for you. trust me on this one: it's not fun.
When I got to Columbia Presbyterian at about 2:00am on Tuesday, I talked them into taking it off. Only problem was, I couldn't really breathe without it. They gallantly tried to leave me with just a regular oxygen mask, but I think we all knew that wasn't gonna work. My siblings came to see me and as they tried to converse with me, they realized I was so winded I could barely talk. At about 4:30pm, February 2nd, the decision was made to put me on a ventilator. It was a decision that would ultimately save my life; it also changed my life forever.

Vrumi to the Rescue!

I have always had this tendency to trust doctors too much. I usually believe what they tell me and usually assume they are competent, unless proven otherwise. I had my doubts about Dr. Aitemen. The only thing he had going for him at this point was Dr. Katzenelenbogen's recommendation. He had pretty much been a no-show during my 2nd stay at Beth Israel. Because he was ostensibly in charge of my care there (or lack thereof), it would therefore follow that he should be held responsible were I to develop some sort of exotic complication. Like death. But like the trusting (read: stupid) soul that I am, it never seriously occurred to me to transfer the hell out of there. That's where my brother came in.

Vrumi loves this kind of stuff. Not that he liked the fact that I was so sick, G-d forbid. He loves getting involved with searching for and/or checking out doctors. He won't go to someone for a hangnail without checking him out first. There's this organization, Refuah Resources, run by a Rabbi Shuki Berman. He has lists of the best doctors in New York and beyond, for just about any ailment imaginable. I'm pretty sure my brother has him on speed dial. Unbeknownst to me, Vrumi called Shuki and came to see me in the hospital. Knowing what a stubborn (read: real stupid) dope I can be, he broached the subject somewhat cautiously. What did I think, he asked, about transferring out of Beth Israel. He told me he had checked around and was told that the worst pulmonologist in Columbia Presbyterian was better than the best one where I was. I was feeling so lousy, I almost said okay. I called Dr. Katzenelenbogen and asked him what he thought. When he said "not a bad idea," it sealed the deal. We called for an ambulance and headed uptown.