Today, on the phone, Dr. Fields told me to take aspirin for fever, Imodium for diarrhea.
I’d read on the Internet it was harmful to take Imodium, that it encourages C. diff. to bloom. But what do I know? I’m too scared and weak to think straight. I took an aspirin. I swallowed an Imodium caplet.
I’m a good patient.
The clerk who admits me at County Hospital is not interested in the fact that this is my fourth trip to an emergency room or that this mysterious infection vanished before recurring. Just the symptoms, ma’am. She writes up her form and points me down a corridor through a set of double doors that magically opens, as if I’m entering hell or Xanadu. Maybe both. By now, Marc has parked the car and caught up with me. We enter my curtained ER cubicle. I curl up under the covers, Marc on a plastic chair beside me.
“I’m Dr. Jones.” A friendly young man in a white lab coat pulls back the curtain. “What seems to be the trouble?”
I give him the blow-by-blow with as many lurid details as I can remember. I make it sound as bad as possible. I want the works: every high-tech test performed now. I will refuse to leave the hospital without a diagnosis, a cure.
“We’ll run some blood tests,” he says, upbeat. “And a CAT scan, just to make sure.”
A CAT scan! I’m thrilled. I want this superhuman machine peering beneath layers of skin, muscle, tissue, bone, into the core of every organ. Is my kidney acting as a kidney? Liver, a liver? Stomach? Intestines? Pancreas? Bladder? I barely know what else gently throbs beneath my skin’s surface. I don’t understand the purpose of a pancreas, I realize. I don’t question my body. Who wants to know how a body functions? To visualize the inner workings is horrifying. I just assume that every part knows its job and performs dutifully in order to keep this organism known as “me” functioning.
But who am I, really? I always imagined myself in terms of my mind, what I think, as well as how I appear, on the outside. I have reddish hair and hazel eyes. I’m five feet, three inches. Before I got sick, I weighed about 115 pounds. I’m a liberal Democrat. I vote in every election. I teach. Isn’t this me? Who wants to know more?
But this doctor could care less how I voted in the last election. He doesn’t care whether I struggle with being Jewish or not. He wants to know when I last went to the bathroom, what I ate for dinner. “Does this hurt?” He probes my stomach. “This?” So now, wheeled into a giant doughnut of a CAT-scan machine, I imagine “me,” who I am, differently. All of who I am is simply contained in a sack of skin. Without this body in some semblance of working order does the rest of me matter?
This isn’t my first CAT scan. About two years ago, a routine physical turned up blood in my urine. Three sonograms, one CAT scan, and a clean urine sample later, nothing was found to cause the abnormality. However, the CAT scan showed a speck of “something” on the lower tip of my lung. “It’s probably nothing,” the doctor said. “These new machines are overly sensitive.” But just to be sure, the doctor ordered another CAT scan.
Nothing was found then.
Nothing is found now.
“The CAT scan is negative.” Dr. Jones proudly smiles, as if it’s his body. “Everything looks perfect.”
“So what is it, then?” I ask.
“Hepatitis A,” he says, with confidence. “You have an elevated ALT level, and that’s an indication of hep. A infection.”
The nurse arrives with an IV, for fluids.
Dr. Fields’s Office, November 28
“Hepatitis A?” Dr. Fields exclaims. “Where would you have gotten that? Nothing points to that.”
“A slightly elevated . . .” My voice trails off.
I spent Thanksgiving weekend thankful for the hepatitis A diagnosis, the least serious of the hepatitis alphabet—no active recovery regimen, just let it run its course. “In a few weeks, you’ll be fine,” were Dr. Jones’s last words as they rolled me from the emergency room in a wheelchair.
Marc, who has driven me here to Dr. Fields’s office, and I glance at each other and shrug. “I guess I picked it up somewhere,” I say lamely, my euphoria flattening as yeastily as it’d risen only a few days before.
Dr. Fields appears stymied, not the look you want to see on your doctor’s face. “How often have you gone to the bathroom today?” she asks.
“Twice.”
“Well that’s good,” she says, wanting to cheer us up—since I probably went about twenty-three times over the endless Thanksgiving weekend.
“But she’s not eating,” Marc says—Marc, who is usually shy and mild-mannered. “That’s the only reason.”
It’s true: I’ve virtually stopped. I’ve lost over ten pounds since October 30.
“Well, let’s get her on an IV, then,” Dr. Fields says. “Maybe now it’s time to call Dr. Bright for a colonoscopy. A C. diff. infection or Crohn’s disease wouldn’t show up on a CAT scan.”
My dehydrated skin is the texture of leather: black-and-blue bruised leather, from all the IVs. The nurse, searching for a vein, is unable to penetrate it with a needle.
After talking to Dr. Bright, the gastroenterologist, Dr. Fields orders me back to County Hospital. Dr. Bright needs more lab tests before he’ll perform the colonoscopy. Besides, maybe a nurse at the hospital will be able to hook me up to an IV.
County Hospital, November 28
I’m assigned a room in the main wing, even though I’m not scheduled to stay the night. My roommate is a suicide survivor under a twenty-four-hour watch. It’s not clear why the two of us are paired in a room together, given such dissimilar symptoms. Except that the very randomness itself is symptomatic. But symptomatic of what—like whatever disease I have—is difficult to say.
Now, since Dr. Bright needs more lab-test results, of course I’m unable to provide a stool sample. I’m dried out. Nothing is left. So they feed me anything I want. I realize I’m famished, starving. I devour a chicken-salad sandwich on gooey white bread, an oatmeal cookie, chicken noodle soup, and stewed prunes, which I’ve never eaten before. There’s a good reason. They taste like syrupy dirt. Pond water. Sludge at the bottom of a lake. Initially, all the food stays put in my system. The nurse suggests I walk around in order to speed things along. Up one corridor, down another. Marc accompanies me. Every room we pass is its own stage set or still life of tragedy. I wonder what’s wrong with each patient. They probably wonder the same about me.
Later in the afternoon, Dr. Bright gets his specimen. After about a half-dozen useless attempts, the nurse finally plunges an IV into my leathery skin. For four hours I watch the IV bag drip.
I sense the suicide patient on the other side of the curtain. She rustles the sheets. Apparently she overdosed. They pumped her stomach. Maybe this is the connection: we’ve both evacuated our skin.
Her young children visit later in the evening. The boy, breathless with drama, informs the nurse that he found his mother, called 911. The little girl pokes her head around the curtain to look at me. I stare back. I can’t even smile, though I’d like to offer her encouragement, help her survive her mother. But who am I to speak?
On November 29, I receive the following e-mail from Dr. Bright’s nurse:
colonoscopy and gastroscopy thurs. 12–1 at Community Hospital. register at 12:15. wednesday 11–30 clear liquid diet. wednesday at 5p. drink 1 and 1⁄2 oz. (3 tablespoons) of fleet phospho-soda mixed in 4 oz of water or ginger ale. throughout the evening you must drink at least 3 eight oz glasses of water or clear fruit juice. thursday at 7am drink 1 and 1⁄2 oz (3 tablespoons) of fleet phospho-soda mixed in 4 oz of water or ginger ale. follow this with one glass of water or fruit juice. then nothing else by mouth until procedure. Fleet phospho-soda is available without a prescription. purchase 3 oz bottle. call if you have questions.
I must be spotless in order for Dr. Bright to perform the colonoscopy the next day. The phospho-soda tastes, I’m sure, like nuclear waste. I gag with each swallow. My skin shivers sweat. Every ten minutes, or less, I am in the bathroom. By two in
the morning, the black-and-white tiles on the bathroom floor seem to strobe. I don’t feel the ground beneath my feet. I don’t see my chest rise and fall with breath. I am all fluid, floating the nineteen steps between bedroom and bath. By six in the morning, I am polished stainless steel, scrubbed porcelain. Each cell of my body feels rinsed with astringent. My insides are scoured clean.
I am also desert-thirsty, pristine, parched. I feel light enough to float above the bed. The canary-yellow sheets waver like a flying carpet. Emptiness itself is a balm. It asks nothing of me, of my body.
I fantasize about lime popsicles.
Community Hospital, December 1
C. difficile is generally treated for 10 days with antibiotics prescribed by your healthcare provider. The drugs are effective and appear to have few side-effects.
CDC
I curl up under the covers of yet another hospital bed, now in the gastroenterology wing. My thin, freezing body is cocooned in a heated blanket, just as with previous visits to this hospital. All their blankets are baked in ovens with glass windows. I ask for a new one whenever the warmth ebbs. Finally, I’m wheeled in to the procedure area, where Dr. Bright waits for me. Yesterday I typed a two-page, single-spaced outline of the entire saga to read to him: so I won’t forget anything; so he’ll have a full history, all possible relevant information. Patiently, he waits for me to finish the document. “This time, we’ll find out what it is,” he promises.
“It’s a C. diff. infection,” he confirms, after I awake from the procedure with full-fledged, blesséd amnesia. I remember nothing since the nurse initiated the anesthetic drip. He prescribes Vancocin, a good antibiotic, to try once again to counteract the effects of the bad one, clindamycin. A ten-day supply of Vancocin, twenty-eight pills, 125 mg each, costs $370. One every four hours, a rigid schedule. Who knows what chaos will erupt if I miss a dose? 6:00 p.m. 10:00 p.m. 2:00 a.m. 6:00 a.m. 10:00 a.m. 2:00 p.m. I set the alarm. I stay on schedule.
On December 2, the day after the colonoscopy, Marc buys a copy of the New York Times that has an Associated Press article headlined, “Deadly Germ Is Becoming Wider Threat.” The item, datelined Atlanta, the headquarters of the Centers for Disease Control, warns of Clostridium difficile, commonly seen in people taking antibiotics. The previous year, I learn, it caused one hundred deaths in eighteen months in a hospital in Quebec. Now, according to the CDC, four states (Pennsylvania, New Jersey, Ohio, and New Hampshire) show the same bacteria in healthy people who have not been admitted to hospitals, or even taken antibiotics. The bacteria, now resistant to certain antibiotics, work against colon bacteria. Therefore, when patients take certain antibiotics, particularly clindamycin, “competing bacteria die off and C. difficile multiplies exponentially.” The CDC report focuses on thirty-three cases reported since 2003. Of these cases, one woman, fourteen weeks pregnant with twins, lost the fetuses and also died. The woman had been treated three months earlier with trimethoprim-sulfamethoxazole, for a urinary tract infection. Ten others among the thirty-three had taken clindamycin. However, eight of the thirty-three cases had not taken antibiotics within three months of the onset of symptoms. According to Dr. L. Clifford McDonald, an epidemiologist at the CDC, it’s unclear what has caused this outbreak of C. diff. “In general,” he cautioned, “if you have severe diarrhea, seek attention from a physician.”
Marc buys a package of natural-fruit popsicles. I lie in bed, under the quilt, sucking on one. The winter night is still. The house, after the fluorescent lights and jangling equipment in the hospital, is quiet, dimly lit. The lime-green ice slowly melts on my tongue like an unleavened wafer, transubstantiated.
Hours remain seamless, one dissolving into another, one Turner Classic Movie into the next. Days revolve around black-and-white images, popsicles, and the Vancocin cycle. Is this purgatory? Will the popsicles cleanse or purge me? Severe symptoms subside, though my insides feel chafed. When I wash my face, for example, it hurts to lean against the sink. Rather than constant physical pain, however, I experience discomfort; or, more than discomfort, I fear my body will never again be normal. My skin feels dry, transparent. Not enough moisture even to sweat. My hair hangs brittle, bone dry. My lips and knuckles are raw, chapped. Or maybe it is my soul that is raw, transparent, chapped . . . my soul, waiting to be released.
If so, maybe the illness itself is purgatory. My past is catching up with me after all these years. This interior spiritual desert of a soul never blossomed into a lush, leafy oasis—instead, only miraged another new husband, another new location, another new identity—salvation always just around the next bend.
Maybe it took this loud bodily raucousness to stop me in my tracks. To get my attention. To clamor at me, telling me I’ve been looking for something beyond myself—rather than looking within myself. Now, must I prepare to accept that this is me? That whoever this sack of skin is, is me. Like it or not. Or, no, erase the “not.” Just like it. I must just like me.
I never again hear from Dr. Fields. She never calls to ask how I’m doing. I’m not surprised. I find a new doctor, who orders my files from Dr. Fields’s office. He tells me that the original lab tests came back normal: I never had a vaginal infection in the first place.
I write to Dr. Fields. I must be sure she knows about her erroneous diagnosis as well as about the potentially deadly prescription. “I want to make sure that you never prescribe this antibiotic to any of your other patients. After spending about ten minutes on the Internet it was clear, even to me, that clindamycin should only be prescribed in a severe medical emergency.”
Health insurance covers most of the costs, but the final tally tops $11,000.
Six months after the first symptoms, I still have periodic discomfort and have regained only five pounds of the twenty I lost.
Four years later, Fleet Phospho-Soda, the prescribed medication I ingested in preparation for the colonoscopy, is recalled by the FDA, for possibly causing phosphate nephropathy, or acute kidney injury.
And while I never discover the origin of that ghostly fluttering pain in my abdomen—the cause for my initial appointment with Dr. Fields—it never returns. If it does, I will not attempt to shoo it away. Perhaps I will even welcome and bless it as a signal from beyond, a sign of my heightened appreciation for my body, or at least as a reminder that things could be worse.
The New Pat Boone Show
What a crazy world we’re living in, huh?
Pat Boone
In one week I must feel well enough to attend a Pat Boone concert.
I spent this past month in bed, recovering from that C. diff. infection, leaving home only for trips to the doctor and the emergency room. Now, I hope, by December 9, I will be able to shower, wash my hair, dress in clothes other than sweats and pajamas.
I must look my best for Pat Boone.
Nevertheless, one way or another, Marc, my partner, will pack me up in the car for the three-hour drive to the Macomb Center for the Performing Arts in Clinton Township to see him. More than a year has passed since I barged backstage, unannounced, after his concert in that megachurch in Holland, Michigan.
Now, however, Pat Boone has invited me backstage to meet with him after the concert. He invited me, along with Marc, to have “private time” with him.
I’m so touched to hear from you that I’m honestly having trouble writing this.
Sue to Pat Boone
I’ve barely eaten this past month because of the illness. I lost twenty pounds and look wasted. I am wasted. Even the sun shining through the window plunges me into sensory overload. Ditto when the phone rings. When I turn on a light. When the furnace kicks on. When the snowplow rumbles down the street. I can’t read, either; even words are risky, exhausting.
My body is consumed only with itself, even as it also seems to be consuming itself. Every molecule not sloughed off as a result of the infection is in overdrive, keeping me—this organism known as “me”—breathing. Consequently, everything outside my body—light, noise, movement, words
—is a distraction. Overwhelming.
My sole activity since falling ill is watching the Turner Classic Movie television channel. I’m able to tolerate only black-and-white films since, well, they don’t make movies like they used to, back when smoking was good for you, alcohol even better. What a comfort to watch film noir death scenes, or at least actors trying their best to kill themselves the old-fashioned way. To say nothing of all the dead minks draped over socialites’ shoulders (back when wearing dead animals was fashionable) in movies such as A Night to Remember, depicting the sinking of the Titanic. Which, by the way, struck the fatal iceberg on April 14, my birth date.
I mean, technically, I’m not dying, but since I feel as if I am, I’m oddly satisfied, almost comforted, watching film noir lovers blow smoke rings into each other’s faces.
Night and day the old films spool, the action slow enough for my dull senses, my dehydrated eyes, to comprehend. Forties gangster movies aren’t too strenuous, the high-speed chase scenes probably not careening over fifty miles an hour. Besides, they don’t make gangsters like they used to, either, unambiguously dressed in black, uncomplicated, not a shred of motivation, no harking back to unhappy childhoods (brought to you in living color). Likewise, they don’t make death like they used to, victims melodramatically writhing before swooning into a pool of gray blood. I can relate. I feel melodramatic, myself: seeing Pat Boone one more time is my last, dying wish. Even though, as I say, I’m not dying—at least not yet—and should fully recover.
Hour by hour I watch Angels with Dirty Faces; Beware, My Lovely; Nobody Lives Forever; Dark Victory; All This, and Heaven, Too. I barely distinguish the end of one film from the beginning of another. All the hours this past month blur. I eat a few spoonfuls of applesauce for breakfast. A few grains of rice for lunch, a few more for dinner. One-eighth of a piece of toast, dry. An anorexic fantasy come true, my stomach rejecting the tiniest onslaught of food. My skin feels transparent. Not enough moisture even to sweat.
Pat Boone Fan Club Page 18
