Some Enchanted Evening, You May See A Stranger...

Dr. DePalo's Somewhat Evil Smile

Sure enough, a few minutes later two psychiatrists showed up in my room. One was blonde and pretty, albeit with a rather aloof demeanor, the other with dark, kinky hair, quite unpretty and quite obviously Jewish. She was, however, warmer and friendlier. They took turns asking me questions. I was still in a decent mood, so I played with them, charming their little socks off. They must have left the room wondering what the original shrink was thinking, because within five minutes of their departure the dogs were officially called off and I was left blissfully alone. But not for long; about ten minutes later the man who had been at the nurses' station to witness my little temper tantrum waltzed into my room. What does he want, I thought. For that matter, who is he and why is he in my room? I was not at all comfortable with the fact that this stranger had observed me acting like a horse's pitut and now here he was standing at the foot of my bed. Was he a hospital honcho of some kind? An administrator? Director of Nursing? Were my actions going to have consequences? I'm not usually paranoid like this, but I couldn't figure out what this guy was doing in my room! I think he sensed my discomfort because he did not immediately introduce himself. When he finally did, I almost fell out of bed. "Hello," he said with a smile, "I'm Louis DePalo". Dr DePalo! The man into whose capable hands I would soon thrust my poor, scarred, diseased lungs and have him work his magic and make me a functioning human being again. Okay, semi-functioning, but you get the point. I was positively mortified that he had seen me acting like a complete idiot. I'm not sure why his opinion of me was so important to me at that moment, but it was. He was gracious enough not to bring it up, so of course I, being the way I've been since the lobotomy, brought it up instead. Sorry you had to see my hissy-fit earlier, I said. He smiled. There was something just slightly evil about his smile. I had the feeling that we would have a very interesting doctor/patient relationship, but I was convinced that ultimately we would get along famously.

One-On-One

Mt. Sinai's ER was a trip. While I was there I saw one guy who was bareboot and blind, stinking drunk wandering around, and a few very pungent homeless people as well. The woman next to me had fingers that had inexplicably blown up to the size of sausages, quite literally. The ER doctors had decided that it was probably an allergy but had no clue how to proceed. Me? They just pumped me full of Lasix and waited for it to have the desired effect. It didn't take long before I was peeing like the proverbial racehorse. They had determined almost as soon as I got there that I was going to be admitted, so it was just a matter of waiting for a room. It wasn't long before I was slipping back into a full-blown depression. When I got up to my room Sunday afternoon I asked to talk to a shrink. Bad idea. I was in a miserable mood and despite assuring her that I wasn't gonna hang myself with my oxygen tubing, I must have come across as profoundly depressed (and rightfully so, because I was) and, I guess, possibly self destructive (which I definitely was not). In the most cheerful voice she could muster (which I of course interpreted as nothing short of condescending) she asked me if I was okay with someone staying with me, just to keep me company. That of course meant, "just to keep an eye you". I found out later that this was called "One-on-One". They assign someone to stay with a patient that the psychiatry department has deemed a possible danger to himself. We're talking 24/7. I said okay, figuring, hey, what the hell, it might be nice to have someone to shmooze with. Big mistake. After the first hour or so I was searching for things to talk about; I felt like it was incumbent upon me to entertain my glorified babysitter. I woke up a few times that night and each time there was a new face. I decided that in the morning I would call it off. Only problem was, when I tried to dismiss the girl sitting at the foot of my bed at around 8:30 AM, she would not be dismissed. She told me she got her orders elsewhere. What chutzpah*! Being me, I stormed out to the nurses station and demanded that this ludicrous one-on-one situation be curtailed immediately. Of course I threatened my usual threat, that if it wasn't taken care of forthwith I would check out A.M.A., Against Medical Advice. Hell, I'm even sick of saying it! When the poor, overworked nurse didn't respond quickly enough, I huffed and puffed my way back into my room, pulled out my IV and proceeded to bleed all over the bed and floor. I had intended to get dressed in my street clothes, but first I had to stanch the bleeding, and it took a while. My babysitter sat and watched all this with a wry smile on her face; in retrospect, I'm sure she's dealt with lunatic patients before. I finally stopped the bleeding and stormed back out again (at this point my lungs would not cooperate, so it wasn't really a full-fledged storming...it was more like a spring shower) in my shirt, jeans and jacket and very melodramatically made the turn toward the elevators when the nurse on duty finally responded by telling me that a doctor would be coming to my room momentarily to discuss my concerns with me. Success! I had been bluffing of course, but they had apparently bought it. I was so pumped (boy, I can be a real jerk sometimes), I barely noticed the thin man with the long, flowing white hair standing quietly at the nurses' station, observing the whole scene.

* If you don't know what chutzpah means, you soooooo don't belong here...go find yourself another blog!

Where to, Mister?

As you can imagine, I was very upset. I had had two other B.I.T.R.* before, but this was undeniably the worst. The first one bumped me back into the ICU from a regular hospital room, and the second one bumped me from Silver Lake to Richmond University Medical Center. But now that I had made it home, I expected to stay home. They wouldn't even let me walk to the ambulance. They bundled me up onto a gurney; I had reverted back to being a patient again. Once I was inside the bus, I made the mistake of asking Yisroel Brody, one of the EMTs, a really dumb question: am I going to survive this, I said. I wanted him to say, don't be ridiculous, of course you will. He, of course, had no idea if I'd survive, and told me so. That did not make me feel better. Unbeknownst to me, my brother Vrumi was tailing us up the West Side Highway. My cell phone rang: Vrumi had been discussing the situation with Shuki Berman of Refuah Resources, trying to decide whether it made more sense for me to go back to Columbia or to Mt. Sinai, since my new pulmonologist, Dr. DePalo (whom I had not yet met) was affiliated there. Vrumi then discussed it with Yisroel who in turn discussed it with me. We were literally about one minute away from Columbia when the decision was made to get off the highway and high-tail it to Mt. Sinai. Originally I was against it, but now that we were on our way, I thought it was the right decision; I figured it might be a good idea for my case to be looked at by a fresh pair of eyes (in Dr. DePalo's case, bloodshot eyes, but a fresh pair nonetheless) and by a whole new staff.

* B.I.T.R. = Bumps In The Road

Bump in the Road #3

I was hoping that after the pint of blood I received on Friday, I would feel better over the weekend. Sadly, this was not to be the case. My weakness did not improve and my breathing got worse as Shabbos went on. By the time Saturday night came around, I was in frighteningly bad shape: ragged breathing, very low sats...basically I was a mess. I did not (repeat: DID NOT) want to go to the hospital. Please understand that I've never been a stranger to hospitals. What with the three pneumothorases (collapsed lungs) in my 30s and 40s, three bleeding ulcers, one pericardial effusion and a partridge in a pear tree, my body's been through the wringer. Indeed, I think Maimonides should name a wing after me. After what I went through at Columbia, however, I now equate hospitals with hopelessness, despair and yes, possible death. As I mentioned earlier, I thought I was well on the way to a full, complication-free recovery when I was discharged from Silver Lake. I really wasn't psychologically prepared for this. After a while, however, it became obvious that I didn't really have a choice. Chayie and I discussed calling Hatzoloh, knowing full well that if we did, they would pretty much insist on taking me to a hospital. The thing is, Hatzoloh has a policy whereby they bring you to the nearest hospital available that they consider competent (incidently, that rules out Beth Israel immediately!). They certainly don't transport you out of Brooklyn. Suffice it to say we pulled some strings and before I knew it I was on my way back up to Columbia Presbyterian.

Finding Hemo

I am what I am!

If you recall, I had to be transfused before I was discharged from Columbia Presbyterian (August 27th post). So it was no surprise when Dr. K. told me I was anemic. This was, however,

the first time I was so very symptomatic; I could barely stand. Anemia robs the body of red blood cells (hereafter referred to as RBCs) which in turn produces a shortage of hemoglobin, the iron-containing substance therein. The body uses hemoglobin to transport oxygen from the lungs to the rest of the body. Hemolytic Anemia (where there is an abnormal breakdown of RBCs) can be caused by various antibiotics, several of which I had taken: Bactrim, Vancomycin and Dapsone. Among other things, it can also be caused by chronic illness, and apparently being sick as a dog for five months qualifies. Dr. Katzenelenbogen wanted me to see a hemotologist so we could pin down what was causing the problem so it could be treated accordingly. The one I chose was a nice young man who suggested that before we even know the etiology of my particular anemia, I should be transfused so that I could gain at least a little strength. When I suggested spinach instead I was informed that that only works in cartoons, shattering my childhood illusions. I guess it was for the best: I've always hated spinach. I was scheduled to receive at least two units of blood on a Friday. As it turned out, they were only able to complete one because the hospital was out on Long Island and I needed to get home for Shabbos. So I was rescheduled to come back on Monday to get the rest of my new blood. File this under the catagory of "ah mentch tracht unt G-tt lacht*".

* Freely translated: Man makes plans and G-d Laughs

Next Stop: Methodist Hospital

That Saturday night I felt even worse than I had been feeling, or at least I thought I did. When you've been seriously ill for a long  time, you can start imagining things. Actually, I shouldn't be stating that as fact, but that was my was experience. I would lie in bed thinking, "I'm dizzy. Am I dizzier than I was before? I think my vision is blurry. Is my vision blurry?" And on and on. Understand, too, that at this point I was not yet convinced I would survive. Indeed, I was pretty sure I wouldn't. Ergo, it's possible that many of my symptoms, sans measurability (e.g. pulse oximeter readings), may have been imagined. Do you realize that I just used a Latin word and a French word in the same sentence. Wow, aren't I amazing? Also a word that probably isn't a word (measurability). At about 1:30 AM Chayie and I decided I should probably go to the hospital. We called Hatzoloh and they took me to Methodist, one of the better Brooklyn facilities. A very nice, very pretty doctor whose name escapes me took care of me in the ER. I think she was Greek. I told her I was dizzy, my vision was blurry (maybe) and that I had a headache. Actually, now that I think about it, the pain was in the back of my neck. Technically, that would make it a neckache, I guess. I had convinced myself that I had meningitis. Cute Greek Doctor said I did not. I was glad. They took blood and ran tests and found that my hemoglobin was very low (duh!) and that my potassium level was very, very low. She made me swallow two of the most monstrous pills I ever saw. They were about the size of a DeSoto. She wanted to do a cat scan of my head to see if there was anything floating around inside my skull. I wanted to go home. You see, my mom was staying at Chayie's house that weekend too, and we didn't want her to know that I didn't feel well (more about mom later). I told Cute Greek Doctor that the reason my potassium was so low was because I hadn't taken any since before I got sick, even though I used to take it regularly (Dr. K. had prescribed it). I promised to take it and to follow up with my doctor, yada, yada, yada. She discharged me. I thought about asking her if she liked sick, old Jewish guys, but Chayie was there so I decided to behave. How boring!

Why Don't You Smile?

Don't get me wrong...I love my mother. Only problem is, this old, old woman bears almost no resemblance to my sharp, funny mom. She's depressed, confused and cranky more often than not. That first Shabbos home (or more accurately, at Chayie and Dave's house),
she drove me totally bonkers. As previously documented, I had lost my sense of humor somewhere back in the ICU, together with one sock. I was feeling so lousy that I sat at the Shabbos table and moped, not at all like my usual loquacious, charming self. My mother sat across the table and said, "why don't you smile?" Firstly, this was the quintessential case of the pot calling the kettle black: she was grumpy and depressed herself, quite incapable of practicing what she was preaching. Secondly, because of her total lack of any short-term memory to speak of, she repeated it every few minutes..."Why don't you smile?" "Why don't you smile?" "Why don't you smile?" What's it called when you off your own mother, matricide? Well, I honestly believe that no jury in the world would have convicted me. Another time she got on this kick where she wanted to give me one of her lungs. I tried not to be an ingrate. While I appreciate the offer, I said, I don't think the doctors would be too keen on transplanting a wrinkly, worn out, 90-year old lung into my 59-year old chest. Why not, she countered, it's probably in better shape than yours (I actually had no retort for that irrefutable bit of logic). Again, this magnanimous offer was repeated over and over again. And then there was the time when Mom wasn't happy that I was breathing through a nasal cannula attached to R2D2. "Why do you need that thing," she wanted to know.
"The doctor told me to use it".
"But you don't need it".
"Remember when the doctors told Dad that he needed a pacemaker?
He got one, didn't he?"
"Daddy never had a pacemaker".
Like I said: no jury in the world...

Aren't I Supposed To Be Cured?

Cured

I felt okay at Silver Lake.

Maybe it was because I was
in bed a lot. Maybe it was
because I was a whole lot
stronger when I left than when
I came in. Maybe it was because I was on oxygen most of the time. Whatever the reason, I really felt like I was physically ready to leave. Of course believing that little fairy tale left me totally unprepared for the reality of the situation, which was that I was still really quite sick. The first few days in Chayie's house I was dizzy and trembling and constantly exhausted. What really knocked me out, however, was our first excursion to Dr. Katzenelenbogen. Poor Chayie had to let me out of the car right in front of the office and then look for a spot; I was too weak to walk more than a few yards. It's hard to describe how I felt. I remember thinking, "this is the sickest I've ever been". And that included all the stuff I had gone through since January! Shortness of breath is a difficult thing to live with to be sure, but this was worse. I was so shaky I thought I would pass out. I was so weak I didn't think I'd make it from the waiting room to the examination room. Chayie gave me a cup of water and kept asking me if I wanted more. Did I mention that my sister is a tzadeikes*? She was solicitous almost to a fault. Of course you realize that I usually (read: always) kibbitz with the girls in the office when I'm there. I walked right by them with my walker and didn't even crack a smile. I was soooooo sick. The doctor and I have that kind of relationship as well, and I think he was alarmed not only by my physical appearance, but also by my humorless attitude. Doctor K. (his name is 15 letters long; my fingers are getting tired!) took blood. Cutting to the chase, when the results came back they showed that I was extremely anemic. Get thee to a hemotologist, he said. I said I would.

*Tzadeikes=righteous woman

Where Have All The Doctors Gone?

My first order of business upon my discharge from Silver Lake was to see Dr. Katzenelenbogen. As I mentioned earlier, he refused to take me off Prednisone without consulting with my pulmonologist. Just one teensy problem: I didn't have a pulmonologist. In Columbia I had dozens of 'em, so all I had to do was choose one, right? Uh-huh. That's what I thought, too. Believe it or not, I couldn't find one lung guy in the whole farkahkteh* hospital who was willing to take me on as a private patient. One was not accepting new patients. One was only treating TB patients. One was too busy teaching. One simply didn't want to get involved; he must have seen my 250 page chart. One didn't accept any insurance, and several wouldn't accept my insurance. One smelled like old muenster cheese. Okay, I made that one up. But I literally must have called ten or twelve guys. I figured it made the most sense to get someone at Columbia so they would have easy, unfettered access to my records. Wasn't happening. So I got on the horn and called the two Jewish medical referral services, Refuah Resources and Echo. Refuah really didn't have anyone they recommended highly. Echo recommended a Dr. Louis DePalo of Mount Sinai. I called for an appointment and was pleasantly surprised when the receptionist gave me one just a few weeks away...believe me, when you're dealing with these hot-shot Manhattan doctors, that's a rarity. And they even accepted my insurance! And so it came to pass that I became Dr. DePalo's patient. He's been my Pulmonologist for about five months now, and our relationship is still a work in progress. I know it may sound a bit bizarre to talk about my "relationship" with my doctor, but Dr. DePalo is not your average, run-of-the-mill doctor. He's a character and a half. And, of course, so am I. So anyway, got the scenario? I have an appointment set up with him, but we haven't met yet. Okay...wait till you hear about our close encounter of the weird kind!

*The Yiddish word "farkahkteh" is really difficult to translate, so please just use your imagination or insert the disparaging adjective of your choice.

Some Stuff About Me...

A Different Drummer

This post isn't really about my illness. It is, however, about how I react differently in certain situations than would either of my siblings. One of my shrinks once told me that pretty much every family has what she called the "identified patient". In my family, she said, it's me. Somehow I came out a little weirder than my brother and sister, although believe me, each of them has enough idiosyncrasies to choke a horse. Wait a minute; I don't think horses eat idiosyncrasies. But you get the point. Saying I'm the weirdest of my clan is like saying Prince Charles is the ugliest of the royals, although you'd have to admit that George Brett was no George Clooney, either. Now, where was I? Oh, yes, how I'm different from my sibs. Well, first of all, I'm the one that's been married three times. I'm the one who collects turtle figurines (at last count, there were about 500). I'm the one who, when the doctors told me to get rid of my bird, went and got three more. On any given Sunday Vrumi can be found in a white shirt, dark slacks and his tzitzis* out. I'll be the one in jeans. Always. Chayie will go to kaporos* and swing a chicken over her head. I'll put some money in a pushka* and call it a day. The reason any of this is important is that if one were to look at in the context of my near-death experience, one might expect my relationship with G-d to have changed significantly. Well, it has; just not in the usual, obvious ways. Here's an example: although I spent the obligatory twelve years in yeshiva, my Hebrew is quite poor. I read Hebrew very, very slowly. So when I attend services I find it very difficult to keep up with the sh'liach tzibur* and consequently I either fall behind the minyan* or I start skipping passages. Furthermore, under those hurried circumstances I cannot concentrate on the meaning of what I'm saying, so I wind up repeating everything by rote (unfortunately, that's how many, if not most, Jews pray). So I generally don't attend services; I prefer to daven* on my own, except on Shabbos* or Yom Tov*. I do a much better job communicating with G-d standing by a wall, concentrating on what I'm saying. I also talk to Him when I'm not praying. For years I've maintained that I was satisfied with my relationship with G-d. The nisayon* that He saddled me with this year might be interpreted as an indication that perhaps He was not. So, if You're listening up there, just know that I'm trying to make sense of it all. I'm trying to understand what happened and why. I gotta tell you the truth, I do get angry at You sometimes. After all, You have turned my life upside down in the last year and a half. Was it just to teach me who was really in control? Okay, I get it. Now will You please give me back my singing voice? Pretty please?

* GLOSSARY:
Tzitzis: Fringes Jewish men wear on a special four-cornered garment.
Kaporos: Ritual before Yom Kippur (Day of Atonement) whereby the sins of the participant are transferred to the hapless fowl.
Pushka: Charity Box.
Sh'liach Tzibur: Cantor.
Minyan: Quorum of ten or more men, necessary for certain prayers.
Daven: Pray.
Shabbos: Sabbath.
Yom Tov: A holiday.
Nisayon: A test.

Sprung!



Harvey, the Angel of Death

                                                                                   I don't think
 I can properly describe my feelings during the ride back to Brooklyn from Silver Lake. We were in Chayie's Odyssey. It was the first time I was in a vehicle that didn't have a siren in a very long time. Once again, I started feeling like a human being. Remember those old posts where I described doubting whether I would ever leave the hospital? Doubting whether I would ever return to some semblance of a "normal" life (whatever that means)? This car ride represented an answer. Here I was, crossing over the Verrazano Bridge as a passenger in my sister's minivan, just like thousands of other people heading for the Belt Parkway. People...not patients. In my mind, my long journey back to normalcy was over. I had come face-to-face with the Angel of Death and stared him down and walked away stronger for the experience. Or so I thought. When we got to the Fisch residence there was a "welcome home" sign on the door. Then inside there were two balloon bouquets: one from the Fisches and one from Malkie, wife #3. Think I should propose to her again? I've done it many times since our divorce, and she keeps saying no. Go figure! She's definitely my favorite ex. I have to keep reminding myself that for the 177 days that we were married, we were both pretty miserable. But the birds, Oscar and Tootala, were ecstatic. I guess that doesn't count enough. So there was definite evidence that people actually missed me and worried about me and wanted me around. Of course the evidence could also be interpreted as a sign that everyone was just sick and tired of shlepping to Washington Heights or Staten Island. I preferred the former possibility rather than the latter. I was touched. I was moved. I was home.

Oops!

Here's the screw-up I talked about in the last post. There were two doctors who saw me at Silver Lake.

Dr. Ralph Ciccone is a pulmonologist. Dr. John McCarthy* might have gone to medical school. Dr. Ciccone's instructions upon my discharge were as follows:
"I reviewed his chart from Columbia Presbyterian. He is on a tapering course of steroids [Prednisone]. I would continue this. He is currently being tapered down from his 80 mg per day from April 2nd. This will be tapered to 60 mg for a week, then to 40 mg for a week, then for 20 mg for a week and the patient will need ongoing taper after that."

Take a look at the Med List they sent me home with (actually, it's only a partial list). I was released on May 4th; Dr. McCarthy had me off Prednisone completely two days after discharge! Thank G-d for good ol' Dr. Katzenelenbogen. When I asked him about it, he said it didn't make any sense to him. He was totally uncomfortable having me go off the Prednisone cold turkey. He refused to allow it until I spoke to a pulmonologist. Without going into all the gory details here, suffice it to say that not only am I still on Prednisone now, more than four months later, I'm still on the same dosage. Had I followed McCarthy's schedule, I might not be here blogging. Can you imagine? I would have survived the vent and the infections and the MRSA and the C-Diff and the trach, only to meet my demise at the hands of a neanderthal doctor? Sheesh...what a jerk!
* Yes, it's his real name!

Homeward Bound

Second time was a charm. Eliot & Company tried again to wean me off the trach. This time they were a bit more conservative. We went from capping the cannula for one hour to maybe three hours, then five, etcetera. Anyway, this time it took...I was able to breathe on my own! You can't imagine

Weaning

what a joy it was to finally be oxygen independent after all those months of being tethered to R2D2 or a wall or a tank. I felt like a real human being for the first time in a very long time. Truth be told, I really couldn't walk very well, but I knew I would soon be going home! Home, where my thought's escaping! Home, where my music's playing! I was ecstatic. The fact that Big Brother Oxford was the deciding vote regarding my imminent discharge was of no concern to me; I just wanted OUT! Apparently leaving a nursing home is no simple matter. We had a meeting on the third floor (I had never been higher than the first). It was me and Chayie and Eliot and Stacy (social worker) and a bunch of other people whom I don't remember. I think one was a dietician*. I recently asked Chayie if she remembered who was there and she said "a bunch of people who needed something to do so they could justify their salaries". Hmmm...makes sense to me. There were those little Halloween-sized Hershey Bars, Almond Joys, Mounds and Three Musketeerses (Musketeerses?) on the table. I love that stuff. They talked about a discharge plan but I was too antsy to be paying close attention. The one little detail that I did find interesting was the fact that they were planning on discharging me without oxygen. I wasn't sure that was good idea and I said so. Eliot explained that Oxford had a policy whereby they determined whether or not they would cover oxygen. If a patient's sats were below 90, you got your oxygen: tanks, mini-tanks, concentrator, the whole nine yards. If you were 90 or above, you were on your own. At the time of the meeting my sats were in the mid-90's. How arbitrary! How stupid! Eliot didn't disagree with me, but there was nothing he could do. Anyway, when they noticed that I wasn't paying much attention they just put everything in writing and handed me a beautiful forest green, gold embossed folder with my discharge papers and my diploma (see above) inside. It was wonderful: I hadn't graduated from anything since 1968. Most of the stuff in the folder made sense and was fairly accurate. A few things were questionable, and one little piece of misinformation could well have killed me...stay tuned!

* Here's an interesting little aside. Or maybe not so interesting. You decide. Anyway, when I spell-checked this post, as I always do, the word "dietician" was highlighted as incorrect. According to Blogger, it's spelled "dietitian". Well, that just looked weird to me, so I went to my old standby, Dictionary.com. According to them, either one is correct. Just thought you'd like to know.

G-d Stuff, Part Two

When I got to Mount Sinai (the hospital, not the mountain; I haven't blogged about it yet) I afforded myself of the opportunity to speak to the chaplain. Rabbi Goldstein is a very amiable fellow who was very easy to talk to. The day he came to my room I was in particulalry bad shape: I was having a lot of trouble breathing and consequently a good deal of trouble talking as well. I explained very briefly what had happened to me and again broached the question of WHY? I was still clinging to my theory that my illness was Divine punishment, and it was up to me to figure out what I was being punished for. He saw it differently. Apparently he does not subscribe to the notion of a wrathful, vengeful Supreme Being, but rather a loving, caring Heavenly Father. "Yes, but even a father gives a misbehaving child a potch (slap) once in a while," I countered. Rabbi Goldstein then came up with what I thought was a great line, one I'm thinking of having made into a needlepoint. "G-d," he said, "is not in the potch business". Boy, do I hope he's right! Then the good Rabbi offered an interesting theory of his own. While I found it somewhat esoteric and perhaps even convoluted, it was pretty darn intriguing nonetheless. In Genesis we find that when G-d created Adam, He breathed the breath of life into his nostrils and Adam became "a living soul". What's your problem, medically, Rabbi Goldstein asked, rhetorically. You can't breathe. You can't accept the breath of G-d (i.e., G-d) into your body, into you lungs. And the reason you can't accept G-d is...are you ready for this?...because you don't accept yourself. Whoa! Now that's heavy!

Anyway, I don't know if Dr. Lief and/or Rabbi Goldstein have all the answers, but they certainly gave me some things to think about. What I can say conclusively is this: during my darkest days in the ICU, what kept me going was that I wanted to meet my new granddaughter, Meira, and I wanted to be at my grandson Menachem's Bar Mitzvah. G-d was gracious enough to allow me to partake of those two indescribable pleasures, so I figure I owe Him. I'm not quite sure what I want to work on first (there's soooooo much that could use some fixing!) but I'm going to try to be a better person in general and, dare I say, perhaps even a smidge less self absorbed as well.

G-d Stuff, Part One

Chayie mentioned to me the other day that so far I have blogged only about the minutiae of the day-to-day struggles I've had since I got sick, but not about the big, important things, to wit: why did G-d choose to have my life hang by a thread, only to allow me to survive? Was I being punished? If so, for what? Was it just that He wanted to hear from me a little more often? Was I supposed to die and didn't because of the devastation it would have visited upon my family? Did the myriad prayers uttered for me change His decree? Will the Yankees repeat? The questions go on and on. I assured her that I fully intended to address these very heady issues in the blog, but I couldn't figure out when. I thought I might include them after the part where I get released from Silver Lake (coming up soon!). But now I realize that there is no more auspicious time than right now, between Rosh Hashana and Yom Kippur.

This is the time of the year when Jews around the world reflect on the year they've just had and, hopefully, make resolutions to change behaviors of which they are less than proud. It is the time of year when all the gates of heaven are open and G-d is most accessible. Our fortunes for the coming year have already been decided, but they have not yet been finalized. We have the opportunity to change any evil decree through repentance, prayer and charity.

When I reflect on the year I've just had, I can't help but think that G-d was definitely trying to tell me something. I find myself telling Him (sometimes out loud), "Okay G-d, You've got my attention...what do You want?" I've discussed all these questions with people I respect. The first one to help me grapple with them was my therapist, Dr. Evelyn Lief. Dr. Lief and I had some telephone sessions even before I could manage to start seeing her again in her office on the Upper West Side of Manhattan. At the time I was insisting that my near-death experience and all the suffering that followed was about my being punished for something. Something I did, perhaps something I didn't do, but definitely something! Evelyn, who is Jewish but not observant, had a different theory. You had doctors telling you for over a year to get rid of Oscar, she said. Your response? Not only didn't you follow their advice, you thumbed your nose at them by acquiring three more birds! Perhaps G-d just wanted to show you what a stubborn lunatic you are! Know what? That actually made sense to me.

The Silver Lake Girls and Me

Nurses sometimes get a bad rap. In 1975 Louise Fletcher (left) won a Best Actress Oscar for her scathing portrayal of Nurse Mildred Ratched in "One Flew Over the Cuckoo's Nest". First of all, if you've never seen the film, rent it. Now. In my humble opinion it's one of the best movies ever made. Nurse Ratched is one of moviedom's all-time great villains: petty, vindictive, cold-hearted, cruel. She personifies the all the nasty, robotic nurses you may have met growing up in the 60's and 70's. Fortunately, the nurses of today are a much softer bunch. I've met probably 100 nurses over the past nine months or so, and there were only two I couldn't get along with. Of course a good deal of that has to do with my irresistible charm and rapier-like wit, but by and large the nurses have been very proficient and very kind. And while Columbia Presbyterian, world class facility that it is, had some great nurses (remember Bob?), put them up against The Silver Lake Girls and they pale by comparison. Keisha, Hattie (sounds like "Katie" with an "H"), Maria, Donna, Melissa and Gaby took care of me without making me feel helpless and had an uncanny knack for anticipating my needs. They were warm and gentle and caring. Unfortunately many of their charges are not in any condition to respond to them in any meaningful way. Many of the patients on my floor were elderly, some were suffering from dementia. I was something of a rarity: a relatively young man in an old man's body who needed a lot of T.L.C. The Girls understood this instinctively and gave of themselves freely and without hesitation. Eliot, Director of Respiratory Therapy, runs a tight ship but understands the need to allow patients to keep their dignity and their humanity. This attitude trickles down through his staff, from respiratory therapist Alexandra to nurse Ron (couldn't include him as one of "The Girls"). They all did things for me that were way above and beyond the call of duty. So here's a shout-out to my Girls: Keisha, Hattie, Maria, Donna, Melissa and Gaby...I love you all, I miss you all, and I promise if my voice ever comes back, I'll come back and perform for you gratis. And Maria? Save me some Ativan, okay?

Not Again!

It was just a short ambulance ride to Richmond University Medical Center (RUMC). Kalman wasn't there when I arrived, but he came soon afterward. I was really glad to see him; going to a hospital, especially one where you've never been before, is traumatic enough. If you have to be admitted with no one there for moral support, it's very disheartening. The first thing the ER doctor wanted to do was put me back on a respirator, albeit just for a short time. There was no way I was going to agree to that. That's when Kalman stepped in. Basically he told me to stop being a jerk and let the doctor do his job. The thought of being hooked up to that monstrosity again chilled me to the bone and scared the hell out of me. But with Kalman and the doctor ganging up on me and the latter assuring me that this would be very temporary, I gave in. He was a man of his word: I was removed from the respirator a few short hours later. Meanwhile, I was not aware of all the machinations that were going on behind the scene. My siblings were trying desparately to get me transferred back to good ol' Columbia Presbyterian. Because I had already been admitted, however, the red tape involved in getting me unadmitted was just too much to deal with. I stayed in RUMC and frankly, in retrospect, I'm glad I did. Granted, they are not the world class facility that Columbia is, but a world class facility was not needed this time. A very nice man named Dr. Arsuro was in charge of my case. They ran tests to see if I had a new infection and I did not. I'm not even sure exactly what they did for me, medically speaking, but I was only there five days so I guess they managed to stabilize me. If this all sounds a bit vague it's because I don't really remember much about my time there at all. I'm not sure why. In fact I asked Kalman to help me with the details and he couldn't remember much either. Maybe there was something in the drinking water. Anyway, Kalman stayed with me the first two days of Passover. We didn't have a seder, but we did have grape juice and matzoh. Kosher hospital food is bad enough; kosher for Passover hospital food is even worse. Ugh! I was beginning to miss my old friend the feeding tube. I was discharged on Thursday, April Fool's Day and was soon back in my old room at Silver Lake. Joe was in middle of a soliloquy about how John Gotti was framed by the feds. Ahhh...it was good to be home.

We Interrupt This Blog...

In case you haven't noticed, I haven't posted anything since September 1st. Today's the 6th. I usually post at least once a day. So you're probably wondering why I've been shirking my posting duties with hundreds of cyber-followers out there waiting for the next installment with bated breath.

Baited Breath

Yes, that's how you spell it. It's bated breath, not baited breath. I checked on Dictionary.com. Bated breath comes from Abated breath. Not to be confused with rebated breath, which is something you hold while waiting for your $3.00 check from Rite-Aid to show up. By the way, don't you think it's ironic that I've used the word breath six times already in this post and it has nothing to do with my breathing? You don't? Well, I think it's very ironic. Would you like an example of

Ironic

something ironic? I thought you might. Well, the picture to the right is quite ironic, don't you think? I guess birds aren't as smart as I thought. Or maybe they just don't like to follow rules. And while we're on the subject of irony, Most of the things mentioned in Alanis Morissette's song, "Isn't It Ironic" are not ironic at all; they would fall under the catagory of coincidence, not irony. Okay, here's a contest. This is a three-part contest. Isn't that exciting? Ready? Okay, here goes:
Part One: Name the other two blog posts in which I used a picture of a fish.
Part Two: Name the other seven blog posts in which I used a picture of a bird.
Part Three: Name another song whose title is made up of three words that begin with the letter "I", like "Isn't It Ironic".
Anyone who gets all three right wins a Lexus from Premier Lexus of the Bronx*, but it's a clutch and it's a really ugly shade of ochre. Oh, and you have to go to the Bronx to pick it up. Good luck, eveyone!

PS Silly me, I forgot to tell you why I haven't posted lately! Well, I haven't posted lately because I'm up to the part where I go to Richmond University Medical Center in Staten Island, and for some strange reason I hardly remember anything about it. Kalman was there with me for the first two days (it was Passover) and I've tried to ask him about it several times but thus far we haven't been able to align our busy schedules. Today is Labor Day and I have the day off, and I'm assuming he does too, so maybe we can finally sit down and chat.

*Fine Print Disclaimer:
We are in no way responsible for the veracity of this statement. If you win the contest, chances are you won't get diddly-squat. Come on, you didn't think we were serious, did you?? Boy, are you gullible! Don't you know that when something seems too good to be true, it invariably is? Okay, okay, if you absolutely insist, maybe we can spring for a bag of chips or something.

Bump in the Road #2

Passover was around the corner. I had already missed Purim. I was still in Columbia Presbyterian then, and Feige and Yehuda and the kids had come to visit me. They looked at their grandfather in bed with a tube sticking out of a hole in his neck and a long blue corregated tube with one end connected to the wall and the other end supplying oxygen through the aforementioned hole. It must have been pretty scary for them, because it quickly became quite apparent that they didn't want any part of me. They just steered clear of my bed and watched Spongebob on TV. Thank G-d for Spongebob! So Purim was pretty much a bust. I was hoping that since I obviously wasn't going to be home for Passover, the fact that I was in a Jewish facility would at least afford me the opportunity to attend a Seder and have food that was kosher for Passover without jumping through hoops. No such luck. They had started trying to wean me off the trach. First they capped it with a little red button that snapped into place on the cannula. Then they had me breath nothing but room air first for just a few hours, then eight hours, then twelve. I was handling it pretty well: my sats weren't great but they were still within acceptable parameters. It was the first time I was breathing on my own since before I got sick. I was elated! I had a rough night the Saturday before Passover. My breathing was labored and I felt very congested. I had a nebulizer treatment and had a nurse suction out some sputum. I felt a little better and I was able to fall asleep. Next morning a nurse wandered into my room and didn't like the way I looked. I was really short of breath now. She left the room and when she returned she had Eliot, the Director of Respiratory Therapy in tow, along with a few more nurses. One of them, Keisha, was one of my favorites. I'll never forget the look of concern on her face. I asked her what was going on and she leaned in close and whispered, "your lips are blue, babe". Uh-oh. That can't be good. They wheeled in a massive oxygen tank and hooked me up. I had been on only about 2 liters of oxygen through R2D2; they set the gauge on the tank at 5 liters, the maximum. I looked at Eliot hopefully and asked what the plan was. He said they were sending me to Richmond University Medical Center, a local hospital in Staten Island; same place they'd sent Joe. I couldn't believe it, and I tried to protest, but that's quite difficult to do when you can barely breathe. Suffice it to say, I lost. Kalman happened to call during this crisis and I told him what was going on. Without hesitation ( and without me asking) he said he'd meet me in the emergency room. I have great kids.