Map of life expectancy at birth from Global Education Project.

Thursday, August 04, 2005

Second installment: getting cut

We came to my room, which looked to be up to code. There were two beds in there, with a curtain between them. I got the one by the door, away from the window and the lavatory. My hostess was a very nice looking, very friendly young woman named Debbie. I liked her. In the first place, she didn't try to stick anything up my ass. The deal was, they had this system here called "primary nursing." As my primary nurse, Debbie was going to take care of me whenever it was her shift, and she would have general responsibility for my nursing care. It sounded like a good idea, although I wasn't expecting to need any bed pans changed or fevered brows soothed. I figured, appendix out, two days in the joint, and I'm back on the street.

There I am. The TV gets only one channel. It's showing how a surgeon at Beth Israel has invented a way to construct a new elbow out of surplus ankle bones. Debbie explained that if you want the rest of the channels, you have to pay $4 a day, and I’d have to wait till tomorrow afternoon when they come around to collect. I have nothing to read, and they have nothing to give me. I am left to contemplate my fate.

After a while a guy comes in wearing blue pajamas and one of those frilly shower hats used by women with sculptured hairdos. Is he a nut? No, or at least not necessarily. He's my anesthesiologist. He wants me to sign a form stating that I understand that anesthesia can cause permanent brain damage, paralysis, death, or chipped teeth, but they should go ahead anyway. He looks inside my mouth and approves of the geometry. He injects something into my IV line to "empty your stomach." He goes.

At about 12:30, they finally come and get me. From here, my memory is not so good. I still have to lie down on a rolling bed, even though I can walk perfectly well. We go down the elevator and through some big swinging doors with all kinds of warning signs on them in bright red. There are lots of people around in blue pajamas and shower caps. The male anally obsessed doctor from the ER is there and he gives me a shower cap. "You can be just like us now," he says.

"Do I get a lollipop too?" I thought.

Something happened. It was much later. I was somewhere else. My mouth was dry. I was in pain but the dry mouth was much worse. There were windows at the top of the wall, as though I were in a basement, and there was daylight coming in the windows. That was wrong, wasn’t it the middle of the night? The pain was nowhere, just everywhere, it was a haze all around me or it floated in a ball somewhere above me or else it was in my throat thrust on down and through me like a rod of ice and I needed water.

Maybe I spoke or maybe the beautiful woman looking down at me just knew but she put something wet in my mouth and people were all around me but I couldn't tell what they were doing. My mouth was dry again, so dry it would kill me and this time I know I asked for water. "Wait" the beautiful woman said gently. I begged her but she said "wait" again. We were going somewhere and she put something wet in my mouth again and she was telling me something about my pain, something bad had happened, some part of me was gone but I was alright. Then she was gone and I was somewhere else. Hands were on me and there were machines around me pumping and hissing.

Somebody, somehow, during that day told me again what had happened and this time I understood it a little, but I only remember having the knowledge, not how I came by it. They had opened my abdomen and found a healthy pink appendix. But there was a mass on my colon "like a Robin's egg." I think I remember a doctor telling me that but I don't know which one. They thought it was cancer and that I was doomed.

The operation they performed was called a right hemi-colectomy. They removed the valve between my small and large intestines, and the ascending part of my colon. Then they sewed the cut ends of my intestines back together. I had been in surgery for seven hours. Apparently the chief resident had started to do what was supposed to be my appendectomy. When he found my innards to be not as advertised, he called up the head surgeon, who left his poker game and rushed over to do the actual cutting and pasting.

While I was still in the operating room, they had gotten the pathologist's report. I did not have cancer. I had a solitary cecal diverticulum. The cecum is the place where the small intestine joins the colon; the appendix is near it, hence the mistaken diagnosis. A diverticulum is an outpouching, a little dead-end wrong turn, in the wall of the colon. It had become obstructed, filled with putrefying material, and infected, but the surgeon had not recognized what he was seeing.

Next: The cure for pain

No comments: