Tuesday, December 1, 2009

"Story of a Surgery - Part Two"

The Waiting Area is the place where the patients and their families go after checking into the hospital. (The day of your surgery, my hospital validates your parking for the entire day. I think that’s very thoughtful. People fighting for their lives have enough on their minds without also having to worry about what it’s costing them for parking.)

The Waiting Area serves a dual purpose. People having surgery wait there before they’re called in. Then, after they go, family members and friends wait there, while their loved one is being carved up in another part of the building, thinking, “Earl was right here not long ago; now, he’s asleep somewhere and they’re playing with his heart.”

The two areas – the Waiting Area and the “playing with his heart” area – are divided by these doors. (Or maybe it’s one door, I can’t remember.) The door(s) is (are) the fundamental focal point of the Waiting Area. Through that (those) door(s) walks the hospital attendant, who announces to the patient that it’s time to go in. Through that (those) door(s) comes the operating room nurse, bringing updates on the surgery. And when it’s over, through that (those) door(s) comes the surgeon to report on how the whole thing turned out.

That’s (Those are) a really important door(s).

Dr. M and I are sitting in the Waiting Area pretending we’re not scared, when a man named Jose comes out. He reads some names off a list – I think there were four of them – one of which is mine. The four of us say goodbye to our loved ones (they get to come in later to final goodbyes, though hopefully not too final.) We then follow Jose through the door(s). It’s time to get ready for surgery.

The “pre-op” room is like a dormitory with a separate, curtained-off area for each patient, but they don’t close the curtains, at least not at first. You can see the other patients, sitting on their beds, waiting for what’s next. (I wonder if I look as nervous as they do. Probably yes.) I remember one sportily attired patient turning to me and saying, “Good luck.” I say “Good luck” back. (Or “You too.”) For the first time in, maybe, ever, the sentiment carry serious weight.

Stuff starts happening fast. A nurse arrives, with lots of questions. “When was the last time you ate?” “Did you take your medication?” “Are you currently wearing dentures?” I am introduced to a lot of people very quickly. Nurses. Assistants from various departments. I ask everyone their names. (I believe it will get me better treatment when I’m unconscious.) I remember the lead anesthesiologist’s name was Vince.

Everyone seems in an upbeat mood. Why not? They weren’t the ones getting cut open.

I remain focused and clear-headed. I know what’s coming; yet I feel almost euphoric. Which is unusual for me. I guess it takes major surgery to lift my spirits. I realize that, amidst the scary stuff, there’s something good about this. When it’s over, I’ll have a better valve than the regurgitating one I have now. Also, despite the risk – or maybe because of it – of the many way I perceive the situation, one of them is as a massive adventure.

At this point, my surgeon arrives, wearing an expensive suit – something I’d wear to synagogue on the High Holidays, if it wasn’t too hot. It seemed appropriate, I felt. It showed respect. My surgeon was worshipping at Temple Beth Medicine.

Dr. M is now at my side. It is time to give over my wedding ring, which is usually really hard to get off my finger. They need to use soapy liquid, but they finally slide it down. I think – but don’t say – “Does this mean I can date in the Operating Room?” Nervous humor. Not always appreciated. By everyone. But sometimes, I need it.

I had one thing to tell the surgeon. I’d rehearsed it ahead of time, so I’d be sure not to blow the line at “crunch time.” My last words to the surgeon are these:

“I don’t want you to be disappointed if this turns out to be really easy.”

(The night before the surgeon had called me and I’d told him, “During my surgery, I want you to pay special attention to my brain. I need it for later. Pay attention to my brain. Write it down.” I thought I heard a responsive chuckle, but I can’t be certain.)

During this “pre-op” encounter, my surgeon said something that was extremely upsetting to me. What he told me was this:

“If I can’t repair your valve, I’m giving you a pig valve.”

Why was this so upsetting? One – this was the first time he’d mentioned that he might not be able to repair my valve. Two – a valve-choosing selection (there are three different options) needs to be a joint decision, not just the surgeon’s alone. Three – had I been consulted, I would have told the surgeon that I definitely did not want a pig valve – not just because it’s a pig valve, and when I died, they could bury me in a Jewish cemetery, but my pig valve would have to stay in the lobby – but because unlike mechanical valves (my option of choice), which last a lifetime, animal-product valves have to be replaced in about fifteen years, which means having to through this entire ordeal all over again, and who the heck wants to do that? Not me. And I’d have to, unless I died before fifteen years, which is hardly a happier alternative!

Fourthly, this guy’s springing this on me this ten minutes before my surgery! (Which should really be first on my list, but I put it fourth for dramatic effect.)

At that moment, I was frickin’ furious! Except I wasn’t, because Vince, the anesthesiologist, was already juicing me with sedating medicine through my I.V. Can you imagine feeling livid and mellow at the same time? It’s the strangest combination. Like walking in shoes with no treads on the bottom. You can’t get a firm grip.

The next thing I know, I’m being wheeled down corridors to the Operating Room. On the way there, I can hear myself improvising an accompanying musical score. I don’t recall the melody, but it was part “Ooh-Ah” chorus and part, like, an Indian chant. It was very beautiful, totally resonant with the moment. If they’d have recorded it, they could have played it for everyone headed towards surgery. It might eventually have become the “Road To Surgery” theme song. I could have collected gurney royalties.

In the Operating Room, I remember sliding from the gurney onto the operating table, which appeared to be less like a table than the size and shape of an ironing board. I recall making that move, and then


I apologize for that. This is the Big Moment. The exciting climax that a story that had been unfolding over the nine previous weeks had been building to. This was the Big Payoff. The Shootout at High Noon. We’re heading the crashing crescendo.

And I can’t deliver.

Instead, my mind feels like it contains four or so hours of erased tape.

I was totally and entirely Somewhere Else. Or maybe nowhere. Disappeared in a dark and dreamless descent into…

I have absolutely no idea.

And to be honest, I wouldn’t mind knowing. This Nowhere, it was not at all an unpleasant place. If death feels like that, I would not at all mind going.

At the appropriate time. Which is, hopefully, later.

Much later.

Note: If you’re at all curious about what robot surgery looks like, type in “The Da Vinci Method” on YouTube. I didn’t look. Besides being squeamish, I don’t need to. I wuz deah poicinally.


Max Clarke said...

That's a nice touch from a hospital, validated parking for the entire day.

Glad you mentioned how going under from the anesthesia really took you out, unlike that man who woke up from a coma after 23 years, and the reports are that he was conscious and paralyzed, not comatose.

Will read the next post carefully to see if Dr. Robot stuck you with a pig valve. As cliffhangers go, that's a new one.

Rich said...

wow, nice 11th hour (surgery-wise, not your life-wise) drop-in by the doc. Kinda like a car salesman. You've already signed off on the car and as you're driving away he's all "oh, by the way...".

I confess that as a resident of the Chicago suburbs paying for parking in a hospital is wholly alien to me.

Can't wait to see how everything turns out! (I presume you live)

A. Buck Short said...

Oh no. Tell me you didn’t get Vince! Anaesthesia isn’t always appropriate. My wife kept shouting for an epidural during the conception.

……… and yet, still, nobody has bothered to ask if it hurts to laugh. Some friends.

So many questions: Did they try that old “promising ice cream afterwards” ruse? How much longer can a Jew go on like this without resorting to the expression, “under the knife?”

In no particular order:
Did you check the hospital bill for validated parking under “ambulatory assistance?” Yours was obviously a class joint. Or maybe it’s just L.A? Here at Baylor, so help me, I use the 10-hr. meters. Thought I had won the lottery until I looked across the street at the row of 12-hr. meters. Incidentally, we’re also a little more conservative. Our waiting area’s have NO LOITERING signage.

Sure those doors present a certain gravitas, but what about the two you go through to get into the elevator and the two others they wheel you out through into the OR on the other side? What is it, a funhouse? As I believe was once said to another Canadian, “Monty, I’ll take the tonsillectomy behind door number 3.” And now they’ve apparently got Leno coming in through an otherwise superfluous glass door every night at 9 – delivering bad news to the soon-to-be Comcast network.]

Finally, belated appreciation to MtB for yesterday’s hypertext tute. (Tutelage is my second favorite activity to accept from anyone when offered. Unfortunately, the first is never offered.) Actually knew the procedure and have used it successfully maybe 30-40 times. Problem is, I’ve attempted to use it maybe 200-300 times. Let me know when they come up with something a little more dyslexia-friendly. As for tinyurl.com , you must have peeked.

Now if you’ll excuse, have to get back to the song parody. A little something to the tune of “Fascinatin’ Rhythm” entitled “Regurgitatin’ Valvin’.”

Anonymous said...

And then... nothing. Reminds me of the Sopranos finale. Glad your run is continuing.

Ms. Sickles if you're nasty said...

It's so great to have you back!