For Lee and Mary
No, this is not about some romantic relationship involving flowers and boxes of candy. It’s about one person’s three day journey through the innards of the American health system. A personal narrative for the benefit of the author’s memory, but a few others may find some interest in the rumination. What follows is all true, though some names have been changed to protect me from lawsuits.
World Turned Upside Down
On a Wednesday I was scheduled for cataract surgery. A benefit of becoming an old geezer. As I am in the waiting room at the surgery center with my son Kit, we are informed that the operating room has been contaminated and the procedure is off. Maybe an earlier patient barfed up in there, or the night cleaning crew left detritus from a MacDonald’s meal break. In any case I am rescheduled for that Friday at the same location.
I was told not to eat or drink after midnight for both the cancelled Wednesday surgical appointment and the now new date on Friday. I live in Arizona, so dehydration may be a problem. On Friday, I arrive with Kit as my ride home. As they prep me for surgery, they take my vitals, and all hell breaks loose.
The nurse scrunches her face and says I have AFib. What the heck is AFib? Some sort of import from a Chinese lab? Apparently, “Atrial fibrillation (AFib) is an irregular and often very rapid heart rhythm.” They slap wired sensors on my chest, and my heartbeat is racing at between 130 and 180 beats per minute. No bueno. This could kill me. Heck, I was feeling as normal as ever. Was it those tacos I ate one day ago?
So the surgery is off (you think?), and the eye people call for an ambulance. I tell them that my preferred hospital is only forty-five minutes away, but they decide I need to go to the hospital across the street. It’s such a short ride that I don’t even get the benefit of lights or siren. They wheel me into the emergency department, park me in a decent sized private room and dump me on a bed the width of a baby crib. At least I’m not separated by just a curtain from someone who is screaming because their appendix just ruptured (am I heartless?).
The Good Sisters
Nurse Gail sweeps in and hooks me up to an IV drip system to slow down my heart. Then she plops several patches with wires on my chest to monitor heart beat, blood pressure and whether my stomach has digested the tacos. I will pay the price later for all of these adhesive patches. I have a hairy chest and having them all pulled off is also no bueno. My first concerning thought, “How will I pee?” The rejoinder, “Well, honey, here is a plastic bottle with a funnel. You stick your private in the funnel and…”
I’m told that I will soon be visited by an echocardiographer. Is this someone who will listen to my words rebound off the walls? No. This is someone who will basically do a sonogram of every aspect of my heart. Will it also pick up the relational travails and triumphs of that heart over the years? So, Cardiac Sonographer Bethany, a vibrant young woman, arrives, puts more adhesive patches on my chest, and I listen to the whump whump of my heart as she visits each part of it. Bethany is extremely efficient, and I decide she can scan my heart for relational tidbits anytime it’s needed. Meanwhile the number of patches on my chest is rapidly increasing.
Most of this time, Kit is also in the room with me, though he takes a break to get junk food for us since I haven’t eaten in over twenty-four hours. Unfortunately a new nurse, thin as a rail, sticks her head in the room, sees what we are eating and sternly castigates us for destroying ourselves and the planet with our food choices. I remark that I only eat fast food every few years (a lie) and thought that since this could be my final meal (the heart thing), I’d go with the double cheeseburger, large fries and chocolate shake.
There Be Dragons
My room is right across from the nurse’s station where the dinging of call lights is centralized. The folks who work here are desensitized to the sounds, but I feel like I have the clatter of pinball machines parked in my head, and I have gotten all the free games I don’t want. Kit is finally able to leave for the night, and I am alone in the room with the repetitive sound of the drip machine, the dinging at the nurse’s station and the occasional beeping alarm from the heart monitor. The only thing that makes this at all bearable is that they have exchanged the uncomfortable platform I was lying on for a hospital bed that they wheel into the room. Snuggle up campers.
I get through the night with a full pee bottle and starts on a second one. After first waking, I decide that while hooked up, I am able to just stand; now I can do my Tai Chi movements, arms going this way and that. Get the blood flowing. Wrong move. Every alarm in the room goes off and a nurse rushes in to see what’s happening. Tai Chi no bueno when in for an irregular heartbeat. They recheck my vitals, and soon, my breakfast is brought in by Rikki Rivera, a certified nursing assistant (CNA). On her days off she is going to school to become an RN. No more having to empty pee bottles. Maybe she should have enrolled in culinary school to improve the hospital food.
A Musical Interlude
So, I am still in the ER instead of a patient room upstairs. I’ve kind of gotten used to the call lights dinging. My wife can’t visit because she is disabled, but I phone her and say that my heart is bigger for her than for any drip machine. There is a shift change, and my new nurse, Denise, is probably in her late twenties. I ask her if she knows the Doo-wop song “Denise.”
“Yes, I was named after that song.”
“Really?”
“My mother would play it on the piano when I was little.”
“Do you know who recorded it?”
“No. I haven’t heard it played in about fifteen years.”
“Randy and the Rainbows in 1963. One hit wonders.”
“I’ll tell my husband. He doesn’t believe I was named after a song.”
“Let me play it on Spotify.”
Oh Denise, shooby doo
I'm in love with you, Denise shooby doo
I'm in love with you, Denise shooby doo
I'm in love with you
Denise, Denise, oh, with your eyes so blue
Denise, Denise, I've got a crush on you
Denise, Denise, I'm so in love with you
Oh, when we walk, it seems like paradise
And when we talk, it always feels so nice
Denise, Denise, I'm so in love with you
“You’ve made my day!”
“Maybe your life.”
It feels good to give something back for the attentive care I am receiving.
Make Way For The King!
Mid-morning on Saturday, Dr. Ky, the cardiologist, enters the room. He is about fifty, tanned, wearing a golf shirt and pressed slacks. Have I made him miss his tee time? He is not pleasant or unpleasant. Just very much to the point. I’d give him a B- on the bedside manner scale. Not bad since I gave my previous urologist a D. “Wear this colostomy bag for three weeks and take two aspirin a day. Maybe we’ll chat again about kidney stones.” Dr. Ky purses his lips and says four things: I’m not going to die; they will now put me on a pill version of the drip for irregular heartbeat; prescribe a blood thinner to prevent clots; and tacos don’t cause AFib. Apparently no need for questions, so Dr, Ky is off to the golf course.
The Cobbled Road
They give me the pill for irregular heartbeat and say that within the hour I can be transferred to a regular room upstairs in the observation wing.
It’s been about 28 hours in the ER. And while that’s no record, I still think I should get a bronze medal for longevity. As they shut down the machines I have been hooked up to, Denise starts ripping off all of the adhesive patches on my chest. I think enough hair comes off to make an afghan blanket.
I’m ready for the trip upstairs. A smiling Rikki shows up to escort me. I want to walk, but they keep me in the hospital bed for transfer. Legal stuff I figure. It seems we travel forever to get to an elevator. Rikki pushes the bed in, and it’s actually a tight fit. She hits the button for the 3rd floor and that’s when it happens (I’m not making this up). An empty pee bottle hooked at the end of the bed is knocked off by the closing door, falls in the track and jams the door partially open.
The alarm goes off. Rikki is not smiling anymore. Neither of us can reach the pee bottle. She pushes all kinds of buttons trying to open the door but no bueno. I look to the ceiling for an escape hatch like in the movies, but nothing there. I say, “Rikki, can you call someone?” She finds the wall phone, picks it up, and eventually we hear a pleasant voice say, “May I be of help?” Rikki spits out, “We’re in an elevator on the ground floor; the door is jammed partly open!” The melodious voice says, “Just one moment.” Suddenly the door opens, Rikki is able to then retrieve the pee bottle and the door now fully shuts. Rikki says thanks on the phone, and the calming voice purrs, “Enjoy the rest of your day.” I tell Rikki, “This has been a great bonding experience.”
Castle Keep
As I settle into my new digs, a room with a view of the mountains and its own toilet, I await being hooked up again to some floor monitors. Instead, the medical assistant places new patches on my chest and attaches me to a small device that fits in the pocket of my hospital gown. A monitoring device with enough computing power to get me to the moon and back. A faceless person in a room nearby is spending countless hours looking at my heart rhythms. Some career path.
I hear a nurse practitioner with a cheery voice tell a patient across the hall, “You will be discharged tomorrow, and if you’re still alive in two weeks follow up with your primary care doctor.” Great advice. So, my dinner arrives. It’s a lasagna dish that looks like it was cooked with a blow torch. The accompanying vegetables have the consistency of mush. Hey it’s fuel.
Later that night I have a real hankering for chocolate. I am told that there is a vending machine near the cafeteria on the first floor. Since I am now ambulatory with the monitor in my pocket, I set off on the trek to satisfy a sweet tooth. After a confusing maze of empty hallways, I finally reach said vending machine. I swipe my debt card, no response; try again, nothing. I shove dollar bills in the money slot. The machine spits the bills back out. I can almost touch the Peanut M&Ms through the glass. This is how my evening ends? I notice a slot at the bottom of the card reader. Push in the card. Voila, it reads it. I get my yellow pack of delight and head back.
End Game
The night passes pleasantly enough with twinkling lights of the city coming through the window. And I only have to get up for a bathroom break every couple of hours. No pee bottles. The next morning the cheery nurse practitioner comes in to discharge me. I sign reams of paperwork, and I am to follow up with my regular cardiologist. She says nothing about me only living for two weeks. My son drives me home, but first we stop at a 24 hour pharmacy to fill an important prescription. There will be a delay; the medicine is coming from China along with a shipment of fentanyl. Maybe I do only have two weeks to live. Our second stop is for tacos.
Once home, I reflect on the last few days. Health care is often a tedious and demanding field, but more often than not, those who work in it are patient friendly and truly caring. Not all emergency departments are made equal. Pray for ones where you are not parked on a gurney in a cluttered hallway. Treat your heart monitors like friends, and they may be friendly to you. Hospital food is designed to keep you alive, nothing more. All bueno.
A day after discharge, I am still finding monitoring patches on my body. True souvenirs of a heartfelt journey.
Robert Matte Jr.