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.