In the Land of the Knife Wielders
churning-open space-no boundaries-beating beating beating- heart- sweat damp-spinning, "Panic!" beating- damp churning "Panic!" spinning "Panic Attaaack!"
Coming out of anesthesia I punch out the words through foggy bedlam. My wife grips my clammy hand. A wraith in white approaches with a long syringe.
The pictures of course are in color. Dr. Sasha Taleban, his shaved head gleaming under the fluorescent lights, points out a clump on my large intestine which looks like a fluffy cloud. "This is very interesting. We were discussing this in our last clinical meeting. I have not seen this formation before."
I note the look of pleasure on the good doctor's face. He has not seen this before. His manner is professional, but he also exudes a genuine warmth. We are explorers together. My colon and his curiosity. "It doesn't appear cancerous, but we should do a second colonoscopy with a biopsy of the tissue, just to be clear." Dr. Taleban slowly peers at me through his black rimmed glasses and reiterates, "I have not seen this before, so very interesting." Leaving the sterile white box that is his office, I have a certain unease about my condition, but am buoyed by the fact that my colon may be on the forefront of medical investigation.
On my way home, a late summer monsoon drenches the car as wiper blades beat a furious wap wap wap. Dr. Taleban, not related to the Talaban who turned Afghanistan into a special version of hell, has just given me the results of the biopsy on my now famous colon. "I can tell you that there appears to be no cancer, but this interesting formation could be precancerous. We recommend surgery to take out the impacted area." Imagine several doctors, clad in their white coats and stethoscopes, sitting around a large conference table with slides of my colon being projected on a large screen. "So Sasha, where did you find this patient. His colon should be presented in the Journal of Curious Gastroenterology." Do they simply want to cut into this bag of bones to turn me into a white paper to present at their next convention?
Dr. Valentine Nfonsam, surgeon extraordinaire, is impeccably dressed in a gray stripe suit, tailored shirt and powder blue tie. He also has a shaved head. Is this a requirement in the Gastroenterology Dept? We are in his softly lit office to discuss my colon. I feel underdressed in jeans and a washed out cowboy shirt.
"I have looked at the photos. The area in question is very interesting. It is not a large area, but I recommend surgery. I have consulted with Dr. Taleban. You may never develop cancer here, but then again you might. It is an important decision."
Dr. Nfonsam's lilting voice draws me in. He speaks precisely which mirrors his strong fashion sense. His Central African roots inform the correctness of his carriage. This is a guy I can do business with. I fool with the pearl buttons on my shirt.
"Well, doctor, can you wear that suit when you operate?" I didn't say this, but I hope he looked as good in the operating room as he did in his office. I also hope he knows how to handle a knife.
"We can schedule you for next Friday. My assistant will give you the particulars. Any questions?" I want to ask the odds of bleeding out. Whether I will have to eat gruel for the rest of my life. Can I get a DVD of the operation? Instead, my response is more mundane.
"The only operation I've ever had was on my tonsils when I was seven. How long is the operation and how long is the recovery?"
Sensing a hint of desperation in my voice, Doctor N. attempts to put me at ease. "I sometimes do three of these operations a day without taking lunch. You should be fine."
Predawn, sitting in the sparse surgical waiting room, the countdown has begun. I have left my youth in the rear view mirror of the 50s and early 60s. With me I have clean underwear, a toothbrush, and a paperback about alien abductions. I wonder what kind of operations they do on the mother ship. My wife is reading Psalms in her Bible. I've told her to stay away from the 23rd. In a couple of hours I will be comfortably laid out on a stainless steel table with an anesthesia mask over my face and Doctor N about to expose my guts to curious onlookers. This is a teaching hospital, so first year residents, all tricked out in pale blue gowns and surgical masks, will undoubtedly be taking turns poking around on my insides. "Look at that colon, ladies and gentlemen; you may not see one as interesting as this for some time. We will remove the affected section and preserve it for years of intensive study. Who would like to make the first incision?"
churning-open space-no boundaries-beating beating beating- heart- sweat damp-spinning,"Panic!" beating- damp churning "Panic!" spinning "Panic Attaaack!"
Coming out of anesthesia I punch out the words through foggy bedlam. My wife grips my clammy hand. A wraith in white approaches with a long syringe.
I wake up again in my new home away from home. The disorientating panic attack I experienced earlier is apparently not unusual for folks administered that particular anesthesia. Nice to know, guys. My life is now defined by a sickly green 10' x 20' room which consists of a huge hospital bed, adjustable side table, retro wall mounted TV and a corner nook with a stained vinyl loveseat and a small window that indicates a world out there somewhere. I also have a small bathroom with enough stainless steel security rails to outfit a battleship.
This space is for one occupant, me, so I don't have to share with a roomy who wants to watch I Love Lucy reruns and has an extended family that visits constantly, telling stories about Uncle Homer's lung operation back in the old days. I am alone most of the time; out of circulation, dependent on others to make me whole again.
They have me hooked up to an iv drip line so I don't get too dehydrated. A needle is also jammed into my left hand, attached to pain medication. I push what looks like a detonator button when I want to shoot the juice into my hand so that it will coarse through my veins, providing temporary relief from my clear discomfort. Why is there discomfort? Well, along with a chopped up colon - a long incision scar and staples make my stomach look like tracks laid for the continental railroad.
The first night in my room leaves something to be desired. This is not summer camp. No soothing cricket sounds here. I am hooked up to clicking machines, and must endure the incessant noise created by call buttons in other rooms. Every couple of hours some shadowy figure is waking me up to take my vitals. Too weak, tired and tethered to get up during the night, I have been given a plastic jug to pee in. If I was a long distance trucker I would chuck it out the cab window, but the window in my room is hermetically sealed. so the nurses or patient care technicians (PCTs) will just have to deal with it.
I figured operation on Friday - home Saturday afternoon. How big a deal could it be? Dr. Nfonsam does rounds Saturday morning, closely trailed by his resident doctors and a couple of medical students. He is wearing a long white coat that is so starched, it could walk on its own. Underneath he is wearing a stylish blue suit and a paisley silk tie that must have set him back some serious dinero.
“How are you feeling today?”
“Like my insides have been through a Waring blender.”
“That is normal, one day after the operation.”
“When do I go home?”
“You must first pass gas and hopefully have a bowel movement. That can take two or three more days.”
“When do I get to eat and drink?”
“Maybe tomorrow you can have water and some pudding. First, your colon must wake up. It has just been through a lot.”
"How much did you cut out? A couple of inches?
"No, more like a foot. We wanted to make sure we got all of the questionable area." The residents all nod in unison. "Don't worry, your intestines are still very long."
The residents hang on Dr. Ns every word as if he is God. They look at me with sympathy as they imagine the big steak they are going to have tonight. All I get to do is suck on a wet sponge on a stick for the next couple of days. As they move on to the next patient, the last resident, a slight woman in her late twenties, says, "You do have a very interesting colon."
They want me walking as much as possible. Twice a day I do ten laps around the nursing hub which looks out on a horseshoe of patient rooms. Eschewing the drafty hospital gown, I am dressed in blue and green plaid pajama bottoms (MacDonald clan?) and a rust colored tee shirt that says, Roswell - The International UFO Museum. I am indeed a stranger in a strange land.
As I make my circuit, gripping the wheeled stand that holds my iv bag, I pass the rooms of fellow surgical travelers who are about to go on living or go on dying in their sanitized cocoons. As I complete the tenth lap, the announcer is barely able to contain himself. "LADIES and GENTLEMEN, a NEW world record in the Senior Olympics. Ten laps in 8 minutes and 43 seconds!" Those in the nursing station applaud loudly as I triumphantly return to my room.
The nurses and PCTs have been as attentive as is possible in an environment where they are always stretched thin. I write their names down. When this is all over, I plan to drop off gift cards for a local sandwich shop. Food is a welcome palliative when caring for demanding patients. Dan, one of the PCTs, is particularly friendly and at ease with himself. He is going to the university and wants to become an orthopedic surgeon and is willing to empty jugs of pee and take temperatures at 3 am if it will get him closer to his goal.
While most of the nurses are more than competent, I run into a young charge nurse named Andrea whose haughty mannerisms are better suited to the queen of the hop. She looks right through me without connecting and fails badly at trying to insert an iv line. "Well, I don't know why this didn't work. You must have bad veins." She and I are rescued by an old hand from another floor who has been easily accessing patients' veins for the last forty years.
During the day, I have the requisite number of visitors. My brother in law brings me donuts I can’t eat, my pastor brings me the Word of God and my wife brings me the comfort found in thirty-five years of marriage.
“The dog threw up in the flowers again. She really misses you. And the plumber said it may take him two days to find the leak. The tailor called and your pants are ready.”
My wife is also employed by this same hospital, in the lab that will biopsy the one foot section of colon that they just cut out. How odd that a recent part of me may only be a few feet away from her work area.
The third evening I wake up with night terrors. Where am I? How did I get here? What year is it? Why is my mother scolding me for wearing dirty underwear? I finally start to calm down and buzz for a nurse. They are allowing me to drink water, and I want a biiiig glass. I feel detached from the world; trapped in a moment where I am just a faceless name on a hanging clipboard.
Eureka! About seven a.m. I have my first explosive release of gas and it certainly isn't SBD (silent but deadly). I am so excited, that I have the nurse record the episode immediately. Kind of like discovering the big geyser at Yellowstone. This may be my ticket out of here. I am iv free and taking pain meds orally. Where are my clothes?
Dr. N. and his minions show up later that morning. This time he is wearing A cranberry suit with a cream shirt and gold tie. The man knows how to make an impression.
"We have been told you passed gas this morning?"
"Yes, sir. I certainly did." I imagine Dr. N and the minions sitting around a large conference table as the incredible news was brought to them by special messenger earlier in the day.
"This is an important sign. Also, I am pleased to say that your biopsy was negative. Very good news for such an interesting colon." The minions beam in agreement.
"So, do I get to go home?"
"Plan on tomorrow morning. But you will not be fully recovered for some weeks. Do not stretch or lift heavy objects. You should move carefully."
Should I tell him that the heaviest thing I've lifted in the last six months is a 12 pack of Diet Coke? That my roller skates have been gathering dust since my kids were little at the Roller Rink?
"We will continue monitoring you today. Hopefully you will now have a bowel movement. You also are allowed to eat solid food." Great! Maybe I can order out and Col. Sanders himself will show up with a big bucket of fried chicken, mashed potatoes and calorie killing gravy.
"We will see you in three weeks for a follow up."
"Thank you doctor, and also your staff." (Will they also be at the follow up???)
I never thought runny eggs, limp bacon and burnt toast could taste so good. The hospital kitchen has done themselves proud. My first meal in days. To top it off, I tightly grip the handrail in the mini bathroom as my first "poop" fires out as a calcified cannon ball.
Soon, I will reenter the world, completing a successful mission that navigated the dark side of fear and the light side of medical competence. On the last morning, I am at the end of a conversation with Joaquin, a forty something political refugee from El Salvador's civil war, who works for housekeeping: cleaning toilets and sinks, emptying trash, changing linen and mopping floors.
"Well, look, thank you for what you do for us in the hospital."
"It is a way to serve others, like I did in my small bodega in El Salvador. My country's name means The Savior. But it is this country, America, that has saved my family.
"I am glad you are here."
"My son. Manuel, has been treated at this hospital. He wants to become a doctor."
"That is a good dream. Don't let him give it up.
Later, with my wife's help, I pack up some final items. This room will soon host another adventurer. I pray that Manuel will be a good doctor, that someday, he will find "a very interesting colon."
Robert Matte Jr.
