Tag: #medicalbureaucracy

Chapter Four – Thursday, May 2, 2024

At 8 a.m., I awoke to find that my older son Kalen had arrived from Tallahassee. He took a 6 a.m. flight to Miami and then got an Uber from the airport to the hospital. Kalen and Leslie apparently had coordinated this. I knew Kalen was coming but I didn’t remember when. Leslie knew. They had already made the plans. Leslie was going to give Kalen his car so he could stay at our house for the few days while Leslie stayed with me.   

Kalen and Corey are nine years and five days apart. I already noted that Corey was in college. Kalen was a lawyer in Tallahassee. The hardest calls I had to make when I found out just how hurt I really was to them. Both handled the call well I thought. Though I later found out that Corey was terrified of losing me. The idea still haunts him to this day. He and I are very close. He is studying to be a writer, so we have a lot in common.

Kalen on the other hand was born to be a lawyer. I knew when he was four years old that was his career path. He had unusually well-developed negotiating skills even at that age. He knew how to deliver a cogent argument when he thought he was wronged. Some 30 years later, he loves what he does and that makes me very happy.

Kalen is now very happy about my relationship with Leslie. He thinks Leslie is very good for me. He is notorious for reminding me to “Be nice to Leslie.” Or “Don’t be yourself. Think about Leslie.” Kalen thinks Leslie is the “normal” one, which by default makes me the crazy one. Over the years, that has changed somewhat. He has softened his critique of me a bit. While I loved seeing him from my hospital bed, I also hated myself for being in the situation that made him come for this little visit in the first place. Under his professional analytical exterior, I knew he was worried sick, and that it was my fault.

***

One of the strange things about being in the hospital is the total lack of privacy. Aside from the nurses, administrators and doctors who just walk in, we had an unexpected visit from the hospital rabbi. He must get notified when a Jew is going in for surgery or something because he just appeared. We did not request a visit, though I could be wrong about that. I do remember something about a clergy visit and thought even if it would be a priest, it probably couldn’t hurt.

The rabbi was a not a tall man. He was wearing a beige corduroy sport jacket and kippah. (The small head covering that most male Jews wear mainly in synagogue to cover their head in deference to God.) My first thought upon him entering my room was that the jacket he was wearing seemed out of season. It was hot in Miami in May. Why was he wearing a jacket? But that thought quickly vanished. He introduced himself. He told me he came to offer a prayer for a successful surgery and speedy recovery. Then he saw Kalen sitting in the chair. Kalen stood to shake his hand, towering over him. The rabbi suddenly looked thrilled. He started taking something out of a small case. As he did that, he explained that during weekday morning prayers, observant Jewish men wear tefillin. They are small black leather boxes with scrolls of parchment inscribed with verses from the Torah.

Realizing what was happening, Kalen laughed and said, “Mom, only under this specific circumstance will I do this for you.”

Kalen stood still while the rabbi wrapped his arm in a black leather strap and placed the tefillin box on his forehead. Clearly uncomfortable, thinking most of religious or spiritual practices are “voodoo,” Kalen and the rabbi recited the prayer for me at the foot of my hospital bed. It was probably the kindest, most selfless gesture Kalen had ever made for me. I was not allowed to take a photo. He would never want any to see what he’d done. But at that moment, I understood just how deep his love for me was. It was one of the most memorable moments of my unfortunate stay and one of the silver linings I had mentioned earlier.

After the tefillin, the neurosurgeon Dr. Urakov came by. I introduced him to Kalen. He reiterated what to expect for the surgery. He said that they would take me down around 3 p.m. It would take about four hours. The first two hours, he said, he would reconstruct my T4 vertebrae and attach it to my spine with screws and rods. After that he would clean out the shrapnel that lodged in my spinal column.

“Anytime I have to work near the spinal cord, time stops,” he said. “That part takes as long as it takes.”

  The very words “operating near the spinal cord” sent a chill down my spine. Once again, I couldn’t believe all this was happening to me. Kalen and I exchanged a very serious look. Trying to lighten the mood as Dr. Urakov started to leave I pointed to Kalen jokingly and said, “He’s a lawyer. Be careful.” He laughed, shrugging it off and said, “I’m not worried.” I felt like a schmuck.

***

I didn’t know what time it was. I didn’t know the time most of the time I was there. All I knew was how long it was until I was due for my drugs, especially the morphine.

I wasn’t happy that my surgery was scheduled so late. Under normal circumstances, I’d be pissed that I wasn’t the first surgery of the day. I hate waiting…for anything. I firmly believe I was born without a patience gene. I don’t like waiting for anything, especially for unpleasant things like medical procedures because I conjure up worst-case scenarios in my head. In Yiddish it’s called “dreying.” It means mulling something over and over in one’s mind until it makes you more worried than you should be. For me it makes me anxious. And then I get nasty.

Except this time, there wasn’t enough time for me to drey. Things happened so fast. I didn’t even realize I wasn’t allowed to eat or drink anything before the surgery. And I really had no idea what was going to be done to me. All I knew was that it was really serious. Life threatening. I did not have the luxury of putting it off. I was also on a lot of drugs. As I look back, I think the best way to describe my mood was resigned. I wasn’t flipping out. I wasn’t really even scared. I knew I had no choice. Without the drugs I was in unbearable pain and in that IV was Xanax, my second-best friend next to morphine.

***

Leslie had stayed with me overnight at the hospital. He slept in a reclining chair. It was very uncomfortable. Remember, Leslie was injured in the boating accident too, only he didn’t have a chance to get any help for himself. He was too busy getting us home and then dealing with me. Leslie wasn’t with us in the room when the doctor visited. I don’t remember where he went, but Kalen was with me and there was plenty of time before they came to get me for the surgery.

Or so I thought.

Leslie returned to the room around 11:30 a.m. At noon, the assisting neurosurgeon Dr. Tyler Cardenal came to get me. He said the surgery before mine had ended earlier than anticipated and they could take me now. Strangely, I didn’t feel freaked out. I was told to give Kalen my jewelry. Leslie followed me to the Pre-op. I don’t really remember him there, so much was going on. But if I think hard, I am able to recall images and flashes of him and things that he said.

Let me stop for a minute to say that I abhor all of this. I hate being a patient. I hate hospitals. I hate being poked, prodded, or anyone telling me what to do. I hate being naked under an ugly hospital gown. I hate the catheter and the IV. I despise large institutions and bureaucracies. I am convinced that the rules large institutions use were designed to cater to the lowest common denominator. Those rules exist for people who do not think for themselves or do their research. I do, so therefore those rules do not apply to me. I need specifics. Facts that apply to my specific situation. I question generalities. I must know why a rule or regulation is needed before I consider complying.

For example, when procedures require fasting, institutions state rules that there is no food or water after midnight before your procedure. That does not take into account the time of one’s procedure. Someone with a 7 a.m. procedure would have fasted for 7 hours and someone with a 3 p.m. procedure would have to fast for 15 hours. That makes no sense to me. That’s why I have to know exactly how many hours I need to fast based upon the time of my procedure.

Even in my extreme, no-choice situation, I felt no different. My bullshit antenna was up and on high alert. Fortunately, I was coming to this surgery from a hospital room. I was a patient admitted to the hospital the night before from the Trauma Center. I was doped and drugged throughout the entire pre-op stage, so everything had already been done. I guess they didn’t feed me that morning, but I really don’t remember.

The formality now was to meet the operating team and the anesthesiologist. I remember meeting him and Leslie said that he had done business with the guy; that he wasn’t very nice. Not a great foreboding for what was to come. But I didn’t think too much about it at the time. I had passed the point of no return. He said I had to be intubated. I sort of knew what that meant. I really didn’t want to know too much more. And thank God, I was really drugged. I had the IV. I had anti-anxiety meds. I had pain meds, and I was about to get even more. Plus, after the surgery, I was going to be out of pain. Or…so I was led to believe. My recovery was 100% guaranteed. Anything I could do before the accident; I was going to be able to do after the surgery. That was really good news, but what they didn’t tell me was that there was a lot of time between those two things and much, much more pain to get me through to that alleged 100% recovery.

I don’t remember saying good-bye to Leslie, but I knew I wanted him to be the first person I saw when I woke up.

***

“Leslie?” I managed to croak out loud the second I was alert enough to realize where I was. The surgery was over. I was in the recovery room. And I was alone. I was seriously doped up, but I knew enough that I did not want to be where I was. At that very instant, I panicked. My fight or flight response kicked in and I wanted out.   

“Leslie,” I said louder this time with more urgency.

No one answered.

“LESLIE! I screamed. “Where are you?”

I don’t remember who came in, but it wasn’t Leslie.

“Where the fuck is Leslie?” I demanded to know.

No one could tell me anything.

The longer it took for me to get answers, the wilder and more agitated I became.

The memory of Leslie leaving me on the tarmac in the ambulance at Fort Lauderdale Airport came flooding back. Had it only been the day before? I had no sense of time. All I knew was that I was alone, afraid and Leslie was nowhere to be found…again.

 I became belligerent. I demanded to know where my family was?

After what seemed like a few minutes of screaming, but was probably only seconds, a woman approached me and said that my family had gone for dinner.

“Dinner?” I screamed at her. “They went to dinner? Now?”

I was incensed.

“What the fuck is wrong with them?” I continued loud enough for everyone in the recovery room to hear me.  

And then I realized that the inside of my mouth was raw.

“What is wrong with my mouth?” I asked no one in particular. “My cheek is ripped to shreds.”

No one answered me.

Then, all of a sudden, a bunch of people came over to me. They told me where I was, which I had already assumed. They told me that the surgery went well and at what time it ended. They told me how long I had been in recovery and asked me how I felt.

“Well,” I said. “The inside of my mouth is torn to shreds.”

“That’s the anesthesiologist,” someone said matter of factly like that was supposed to make it feel any better.

“And where is my family? They are supposed to be here!”

I had no idea what “that’s the anesthesiologist” meant. But I had no more strength left to pursue this line of questioning. I had exhausted myself. That’s when the orderly came to wheel me away. I was drugged. The inside of my cheek was ripped to shreds and it hurt to talk. I guess I dosed off.

I woke up when I was wheeled into my room.  

“Where the fuck were you?” I demanded the second I saw Leslie. “I was down there the whole time screaming for you. You left me again! How could you do that a second time! How am I supposed to trust you? They said you went out for dinner!!!” 

I knew that saying “you left me again” would hurt him. I was angry. I was afraid. My mouth hurt and I was tired. I knew he felt very bad for leaving me in the ambulance when we got off the plane in Fort Lauderdale. I knew he was second guessing that decision now even if he couldn’t think straight at the time.

But I didn’t care.

I was terrified and he was going to pay.

“I’ve been here the whole time,” he said. Kalen and Corey were here too. “We were waiting for them to call us to come down to you. They never called.”

“Well, who the fuck was responsible for that fuck up?” I spat out to no one in particular. I was livid. My mouth hurt badly, and I was really tired.

“I’m sorry,” he said so earnestly, taking my hand, stroking my face and looking into my eyes.

I managed to slur “My mouth hurts. They scraped the shit out of the inside of my right cheek. It hurts to talk. And I’m really thirsty.”

I was so tired, still under the effects of the anesthesia. I couldn’t keep my eyes open. But I knew I was no longer alone. Leslie was there. He would take care of me.  

I was kind of propped up in the hospital bed. But I couldn’t sit up or move. Leslie put some water in a Styrofoam cup, bent down and held it near my left cheek with a bendable straw so I could get a sip of cold water. I drank some and swished some more around my mouth to ease the pain in my cheek. It didn’t work. It hurt like crazy.

Then I realized I was hungry. How long had it been since I’d eaten? I had no idea. But I couldn’t eat because the inside of my mouth was raw.

Leslie opened a package of small bear graham crackers from somewhere, broke them into small pieces and fed them to me in between sips of cold water. I dozed off again. I don’t remember much else. I was uncomfortable. Pain was everywhere, even in my delirium. But the worst was over.

Or so I was led to believe.