Saturday, September 7, 2013

Procedure part two

      The minutes swirled away. Henry didn't feel sleepy or hungry. He read his book at a regular pace. You tell yourself when bad things happen you will be this way or you'll do that -- you don't know. His boys were staying with one of Emily's co-workers. They were fine. He was fine. Everything was taken care of. He checked the iPad, his father-in-law had seen the update about Emily going into the OR. He had done all he was supposed to do. It wasn't like that one time when he waited too long to call people. Emily's dad hadn't liked that. He'd gotten on the phone and yelled or whimpered at Emily's sister, who also knew nothing.
        Listen, jack -- you sit here watching the pulse monitor and the blood-ox monitor and you wait quietly while she tries to swim up from the Propofol, telling yourself that just as soon as you know she's close enough to the surface to know how she's doing, when you've let her face be the clock, and her open eyes the hour hands, then you can tell me I waited too long. No news is good news. For a while anyway. . .
        But he couldn't be angry with them.
        He couldn't be angry because the type of cancer she had was a "good" one to get, if you had to get it. And the universe said they did. They had gotten it together and thank God it wasn't a bad kind. Another teacher that Emily had worked with was fighting against metastatic melanoma at that very minute. That was all over but the dying. Emily was going to survive.
         He couldn't be angry with his father-in-law because Emily's mother had dropped dead. Sixty-five years old. She had made it through Emily's first operation to take out the breast tumor. Then a week later she had collapsed. The EMTs came but it took them too long to get her heart going again. The next morning she was pronounced dead.
         Death is always pronounced. And profound.

         "Have you heard good news about your loved one?" The man in the big waiting room asked Henry. He was sitting across from him. Where had the woman with the ass-improving shoes gone? Sometime while his head was in Uzbekistan she had left. This man was quite tall, a bit overweight for his height, probably in his mid to late fifties.
         "Sorry?" Henry didn't understand the question.
         "Have you gotten good news about your loved one?"
          "Oh." Henry wasn't sure what to say. "Yes," he decided. He had gotten good news after that first surgery. The tumor was a fast-growing type that responded very well to chemotherapy. The cancer had not spread to the lymph nodes. That was very good news. And it was the one time when tears readily rose in Henry's eyes -- when he told Emily that he let the tears come. Was he holding them back the rest of the time? No. He had moved through a dreamy maze, somewhat numb. You have to bear up when you are the bystander. The mortar round has missed you but the guy next to you in the foxhole is hit. You have no time, no right to bemoan your fate.
          "That's good," the man said, running his hands through his graying hair. "I got good news to. It's not cancer. Thank God. Not cancer."
           But was cancer the worst thing?
           Henry mumbled some vague positive phrases about that being very good news.
           He hoped the big man didn't want to hug him.
           Clearly, there are times when people need to spill their guts to any decent person. Polite meaningless phrases sometimes mean everything, Henry thought. Or not everything. But they may be the best thing a body's got at that moment. A little charity. A little fellow feeling. A grimace made from sympathy.
            About an hour after she went into the OR the beeper went off. Henry had been eyeing if for about five minutes. He didn't want to jump when someone else's beeper went off. Why should he care if he looked like a fool.
            He turned the beeper off and the surgeon walked up to him. For a vascular surgeon the guy sure was portly. He still had on his scrubs and the OR beanie.
            "Mr. Parker. I just came from recovery with your wife."
            "How did it go?" You ask some questions because you've heard them asked. You do a lot of stuff on auto-pilot because making it all up as you go would take to much energy and energy is strictly rationed to the spouse of the patient. Your own body is a costume and this some kind of crazy masquerade you've been compelled to participate in. The labyrinth is always overly elaborate. The fact that its form exceeds the needs of its function is its essence. You know it's a dream. You sleepwalk through it anyway. Jamais vu. You've seen all of this before, strange as that may seem. You were fully aware that death had undone all of the absent ones. You know it will be your turn at some point. You just act like it's all a big secret and that you will be quite stunned when you are old and too weak to lift your head off the pillow. You've seen all this before, worked out the implications for yourself, but no one lets you talk about it. That's what makes it so strange, makes it take on such an eerie quality. Everything you see is perfectly familiar, and not utterly unreal, but tinged with an aura of unreality.
            "I couldn't do anything."
            "I got the port to work just fine. I could find nothing wrong with it."
            "But that other surgeon ran that test. She said it was blocked."
            "I can't answer that," he seemed sorry.
            "But she used a dye. And there was some sort of resonance machine or what not."
            "I know. She could have missed the port and that may have been why it looked like the port was leaking."
             "She said it was clearly leaking. How could she be wrong about that when she's look right at the monitor? Is that even possible?"
             "I can't answer that but I was able to get saline into the port and I was able to draw blood out of it. In order to draw blood you have to have a good connection to the artery."
              "So that means it doesn't leak?"
              By Jove, Holmes! 
              I believe you have it, Watson. 
              "But the nurses at the infusion center?"
              "If they have trouble with it try to get an experienced nurse."
              No shit. The nurse that poked her six times said she had over fifteen years of experience. Henry wanted to see her practice on an orange first. Or maybe guide him in. To her own vein. Or maybe he should have just throttled her.
              Do you know what it's like to watch people take a great big needle and go at your wife? Six times they stabbed her with that thing. Then they went to an IV. Three weeks later it was the same song and dance. They had thought maybe it was from all the initial swelling. Or maybe the port was turned sideways. Or maybe it was a double port and they were missing it. Is this a double? Just how the fuck were you supposed to know that? Henry got on the phone and called the surgeons office that first time they had trouble with it. Is it a double, he asked? No. Nope, not a double, you fucking idiots. Of course, what he wanted to do was pass out because he was having a panic attack but he told himself he couldn't do that now. He was the one that had recline whenever he got a flu shot because needles made him faint every since he was nineteen and passed out when the took some blood. It was practically classical conditioning. He felt a needle go in his arm and out went the lights. He was Pavlov's fainter.
               "Yeah OK."
               "The surgery itself went just fine but when I left her she was pretty upset since we didn't need to swap out the port. And I can understand that."
               "Oh, yes. That's understandable." No, that was autospeech again. He would have to process all of those words later.
               "Give her some time for the anesthetic to wear off. They'll take you over to her in about forty-five minutes."
              More infernal waiting. More sitzfleisch. More patience. Doctors want a lot of patients.
              Those forty-five minutes took forever and took no time at all. He put another update on the iPad, saying that she was out and fine, in recovery. Then he read a chapter of the Russian novel with full comprehension then forgot every word of it, even forgot that he'd forgotten it. Rachel Ray was perky on a large TV next to him until one of the volunteers of an undetermined age came for him, leading him down the same clean halls he'd walked down a month before having the port put in place initially. But we've all walked these same halls a thousand times before. This could be a passageway beneath a pharaoh's tomb. Phlebas walked through these halls, just as tall as you, carrying his wife's purse and clothes. You tread through these oneiric structures trying not to feel too much horror. Be here now, do not fear the future, for it will consume you in due time.
              When he got into the recovery area he found Emily sitting up on her bed. She looked pissed. She had half a dozen kleenex wadded up on her tray. They all had blood on them.
              "Did they tell you and didn't even need this damn surgery?"
              "How could that surgeon fuck up that test when she was looking at the monitor in front of her?"
              "I --"
              "And that stupid anesthesiologist. Jerk. I will not let him touch me again."
               "What happened?"
               "Oh, he said that that might burn a little. It felt like a wasp stung me. It hurt like hell. I told him it hurt and he just put me under. That was the last thing I remember. Ass."
               "And now I can't breathe."
               "What do you mean you can't breathe?"
               "I don't feel like I'm getting enough air."
               "What's your blood-ox level?" He looked at the monitors. They were different from the ones at the hospital in their hometown.
               "Well, your numbers do seem a little low. You are supposed to be near a hundred."
               "And I keep coughing up blood." She hacked into another kleenex and showed it to Henry. Coughing up blood seemed less than ideal.
                "Where's the nurse?"
                "She went to get me some ice water."
                She appeared to be out of kleenex. Henry got her some more. Surely the bleeding would stop. The nurse came back. She was a dumpy old thing and looked half awake. The nurse took the bloodied kleenex and tossed them into a nearby waste can. They got Emily more comfortable and tried to convince her that a bit of rest and sips of ice water would likely be just the thing. Henry watched the blood saturation numbers. The started to drop. At first he was alright. But then Emily had another coughing fit and her spittle was just as rosy. The numbers were up and down but when they got below 90 he felt a chill of real terror. What if this wasn't some annoyance but the sign of something seriously wrong with her long? What if this was some kind of pulmonary embolism? That was just stupid. He was scaring himself, he reasoned. But those numbers. Why did they fluctuate? Why did they keep dipping below 90? He asked the nurse to check her numbers.
              "Maybe we should call the doctor," he suggested. Her oxygen seems kind of low.
              The nurse got an oxygen mask and hooked up the hose to the faucet of air on the wall.
               "How is your breathing? Any better?" she asked Emily.
               "Not really."
               Henry had his eye on the numbers. They were not at all improved. Sometimes they went up but then they dropped down again.
               "I'll call up to the surgeon and see what he says," the nurse told them.
                Henry tried to get Emily to drink some Gatorade. She didn't want it. He could pour into a cup with ice. No. Was she sure? Yes!
              After about ten minutes the nurse came back and told them the surgeon was sending someone down to do a chest x-ray.
              Everything would be fine. This was more like it.
              Henry expected a tech to come wheel Emily off to x-ray like they did him that time he had pneumonia. But when a tech did come he brought an x-ray machine on wheels. The thing was slick. You roll the thing up to the bed. The plate swings up and out. Stand back. Zap. You're done. Very Star Wars.               In an instant they knew that Emily had no pneumonia. The lungs were clear. A doctor showed up. He said he had been in the surgery. Henry had never seen him before. A tall strapping guy straight out of the frat house. He still had his gown on. He listened to Emily breathe through a stethoscope. Everything seemed hunky-dory.
              "But she did cough up a lot of blood and that hadn't happened before."
              "A lot of blood?" the doctor asked.
              "Well, yeah. She coughed into several kleenex."
              "These kleenex?" The doctor was looking at what was left. These were just the most recent samples and they didn't have nearly as much blood as the ones the nurse had tossed.
               "Oh. Well, had they been bright red, that would be more concerning," he told Henry. Emily was sighting there mostly stunned.
              "The other ones were a lot brighter. They're over in that wastebasket," Henry said.
              A bit to Henry's surprise the doctor went over to the waste can and fished out two or three tissues. Henry wasn't sure if these were the darkest, bloodiest specimens. I would like to present the court with exhibit A., being a very bloody kleenex.
              "Oh, that's quite light. Not bright red."
              "It looks pretty bright to me. Usually --"
              "I guess we have different definitions of bright red -- and that's fine. The important thing is that her lungs are clear in the x-ray and they sound good. Her blood-ox is up where it should be..."
               It is? It hadn't been. Henry looked at the monitor. It dawned on him that for those numbers to be good he had been reading it wrong. He had been reading the display for her pulse rate as oxygen -- because that was what the display looked like on the monitors at their hospital.
              But she hadn't been able to catch her breath . . .
             "Sometimes when they put the tube in, they can nick the throat, and that will bleed a little."
             Henry bet they would have different definitions about what constitutes a little.
             It would take him months before he would be himself enough to wish he'd had a Crayola crayon with him. A bright red one. That way he and the surgeon could compare drawings. In medical school they tell you the real names of the colors. They also hypnotize you and convince you that coughing up blood is standard procedure. Apparently, you go into medical school and forget that most people breathe all day long without every coughing up any blood. And all blood coughed up is bright red. It would take Henry many months to think of that, and even longer to see it for the hilarious joke it was. Six years of medical school and the kid gets philosophical about the color red.

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