But I only care for the very few minutes it takes to fall asleep. I’m out by the time he’s back up. I sleep a solid six hours, my longest nap in days, and awake marginally rested if not refreshed. Stuey rises slowly, insisting on a good breakfast, because a man has to eat. He knows a place, and we soon face ungodly mounds of eggs over hash browns alongside ham and toast. I eat slowly. He engorges till he puts his napkin on the counter and says it’s time to go drop the kids off at the pool.
“What kids? What pool?” But he’s off. Watching the grease congeal, I wonder what the day and night just past would have been like in solitude. I don’t doubt my survival, but I would have drunk and smoked less, slept more fitfully and eaten nothing. Doctor Stuey is back in two minutes. “Just that quick?”
“Yeah. It’s a miracle. This place is great.”
I excuse myself to make my bid for greatness. I realize that Stuey is an original pain in the ass and a friend in need. I dispense with fear and morbidity and ease on back to the counter, where Stuey is having more coffee and a smoke. “Yeah, you’re right. This place is great. I have to go now.”
“I’m coming with you. Okay? I want to see her.”
We go in two cars, because I’m staying for the shift. My car bongs for ten seconds and shuts up. I haven’t listened to the radio in three days, or four. I turn it on to the Byrds singing Don’t Fear the Reaper. It assures me that forty thousand men and women every day . . . That was thirty years ago, when it was only forty thousand people dying daily. I flip to jazz, not smooth jazz, but the straight-ahead stuff that helps some people reconcile the contradictions all around us. I’m one of those jazz fans. A tenor sax won’t explain the complexities of life, but it speaks to the beautiful effort we must make in resolving things, in syncopating the challenges with a few swinging eighth notes on the way.
Up again in the ICU, Stuey says he’ll wait. She’ll want to see me first.
I enter slowly. Her eyes are closed. I ascertain her breathing then pick up the new chart near the computer. On top is a printed form issued post-op, a multiple-choice series of questions with a few fill-in-the blanks. The new profile is:
47 yo L temporal 3 cm
INTRAPERENCLLYMAL HSURATEMA
L MCA Bifurcation Aneurysm
• ALERT Anxious Uncooperative
• Responds to voice
• Responds to pain
• Unresponsive
She opens her eyes but doesn’t smile as I finish reading. I sense further symptoms of displeasure with lingering distrust. She displays what is profiled in longhand as anxious and uncooperative. I’m present with moral support, beginning with my opinion that anyone free of anxiety and willing to cooperate in this house of shrinks and disclaimers would require another box to check:
• Bona fide android.
But she underscores my own culpability with a headshake and another complete sentence, “I wish I hadn’t done that.”
“We had no choice,” I remind her. “It’s over now. You’re doing great.”
“It’s not over. Look at me.” I look. She is wired like a control center, pierced with needles leading to narrow diameter plastic tubing festooned and tangled. She complains of a searing pain in her back and a splitting headache. I don’t laugh as I assure her that discomfort at this point is a no-brainer, that pain and a headache are to be expected after cerebral surgery. She doesn’t laugh either, so I don’t press.
From the top of her head, out of the gauze rises a six-inch steel spike connected to a bundle of leads and plastic tubing twisted in a bunch and running to her monitor. These are to measure brain pressure for the critical period of seventy-two hours after surgery. I will ask many people many times what will happen in the event of cranial swelling. I am given mutters and mumbles but no answer, maybe because the team is tired of my need to know, or maybe because the answer could be construed as libelous. I let it slide, and I repress further assessment of extreme potential. I will work with the team, as I’m able to do so, defending my mate’s right to autonomy if not peace. I pause here, as I would come to do many times in the months ahead, to consider the overwhelming need upon us to get along, even as society rears its ugly face. I squelch my natural resistance to being treated this way, and I succeed. Chronic repression can lead to psychosis in the long term, but for the moment it helps prioritize the issues at hand.
Her forearms are pierced with many needles. They dangle from veins near arteries in both wrists. She is bruised with more yellow and purple than a hurricane sky—both wrists to both elbows. The right side of her neck is swollen like a bladder and seeps viscous ooze. The skin on that side of her neck looks like a goiter, dead and yellow, slumped like melted wax. From this misshapen, syrupy mess comes the gang valve with its many leads and a few more leads from valve splitters alongside. This neck apparatus has been re-sutured into place, but its sheer weight tugs at the flesh. It’s difficult to look at. She sees the difficulty in me, and her facial expression sinks further. Then I see that the horribly dead, sloughed skin is not really skin but the packing tape holding the hardware and veins into her neck, to keep all the stuff from plopping out. “Oh, hell,” I say. “It’s tape—not skin but tape.”
She feels it with her hand, pressing and crying out in pain, “God.”
“What?”
“Feel this.” She tugs at her gown. I assist. Between her crotch and thigh is a hacked, purple lump as big as an egg—the femoral artery. I touch it, rock solid. She cries again.
“Sorry.”
“No. My back.”
“Can you roll over? I can help your back.”
She whines and whimpers as she struggles through the tangle of tubing and leads, pushing through the pain, because she knows of the magic in my hands. I pull her gown up and see the punctures left by the spinal taps. They’re a quarter inch across and thick, like rocks are bulging from under the skin. I won’t touch these but put my palms on her back, higher up. She’s burning up. I move carefully, leading the heat and pain out where I can. She mutters regret once more, wishing she’d never come here, wishing her life had ended, if that was meant to be, without this nightmare finale.
In a few minutes I pull her gown back down and cover her. She’s sleeping. The radiance is gone. Now she looks beat and broken, body and soul. She looks beyond the pale of mortal concern, quite willing to stop this process, if not by going home then by going beyond.
I walk into the hall and ask the charge nurse for our nurse. Our nurse is Leah again, and I ask what’s on the agenda for today. I fear a downturn in vital function that may warrant medical urgency, what the system will not call heroic, but I anticipate the heroic motivation. I fear it, with its TV reality, its voltage and drama. Of course that’s just me being cynical and difficult once again, as necessary.
Yet I must consider prospects for more critical needs, for re-entry, with Rachel’s scalp peeled back again, the skull unscrewed, another spinal tap or two and some fiddling around because the repairman couldn’t get it right the first time. I don’t want to suspect that a few adjustments will be warranted to enhance the database but can’t help it. A few more tests could be covered by the insurance and justified in the pursuit of data critical to the great experiment, in which the system will be further proven. She’s so healthy, and a case could be made for shoring up the mean. This sounds irrational, but I am accountable to my mate and determined to defend her, even before the trouble has a chance to begin.
Though I felt relief only a few hours ago, I sense a new arrival, or perhaps a regression. I teeter on a brink between will and default. Sleep can alleviate physical fatigue but not spiritual fatigue. Years ago we agreed, Rachel and I, what we would do when the ball came to us rather than waiting to think it over and losing the play. We would know what to do for each other because we shared an outlook on life and death, because death is unavoidable and in some circumstances should not be prolonged or unduly agonized.
This may not be one of those circumstances, but
the unavoidable feeling is that it may. We agreed in a brief but sobering session to do the same for each other in regard to plugging and unplugging. We went for drinks and danced up a sweat after that strategy session, to forget what would come to pass, to drench the inevitable in oblivion.
We agreed to facilitate passage with peace. We will impart dignity to the space around us, surrounding ourselves with what we love rather than beeping machinery working off a heavy debt service and in fact losing money unless plugged in. Nurse Leah assures me that the surgery will not be repeated in any event. The brain will not be exposed again, nor will the screws be re-torqued or the incision tampered with in any way. This assurance is a relief and is key to our needs, so fragile seems Rachel’s connection to life.
No, the rough part is over, I am told, even if she suffers spasm (stroke) or seizure—over, that is, unless her brain swells. After one last angiogram, Nurse Leah says, we will face no more invasiveness, except of course on our privacy and rationale. She adds this as support and understanding.
“When are we scheduled for the angiogram?”
Leah checks her watch. “About twenty minutes. But first, we have to—”
“No. That can’t happen.”
“It has to happen. We need a baseline for her pressure and flow so we can measure her progress over the next few days.”
“No.”
“We can’t know if she’s failing without it.”
“No. You’ll kill her.”
“I’ll call the neurosurgeon on duty. It’s his decision.”
“You’re a great nurse, Leah,” I tell her. She pauses for rote patronization—she’s heard it before. “But don’t ever forget whose decision it is. It’s not his decision.”
She puts a hand on my arm. “I’m sorry. I’ll get him.”
The surgeon on duty is young but also tired, at the end of a long and difficult shift. He doesn’t stop nodding when Nurse Leah tells him of my concern. He stops nodding only when I correct her by saying that I’m not merely concerned; there will be no angiogram. He breaks into the neurological, clinical and critical needs for another angiogram, without which all the effort so far may be for naught. I reach deep for patience, and I tell him, “You have her wired to ninety-seven vital functions. You can tell her pressure and flow and rate and tempo and altitude and specific gravity at a glance. I’m telling you, and you need to hear me, that Rachel is a tediously happy person, who now verges on emotional and spiritual failure, and that’s why people die in hospitals.”
To my amazement, Leah is nodding now.
“Not one of those machines in there can give you a level of depression. I’m telling you it’s deep, and it’s the emotion most often preceding death. We’re in dangerous territory. You will leave her alone. I have spoken before witnesses. There will be no angiogram.”
He shakes his head in a uniquely forlorn way, different than that of a wise man facing resistance but more of a young doctor denied standard protocol. He’s worked very hard for years and all night long to learn and to serve. We know this. We feel this. We recognize his stature. I saw the same look back in Bremerton, presented with a consent form that allowed us to decline the medivac helicopter.
“Listen,” he says. “We do this—”
“You’re not doing it this time.”
“I have an idea,” Leah says. “I think she’s upset because of, you know, all the IV leads and bruises and the antenna, and they left the dressing on her head, and the tape. I think I can eliminate some of the twelve leads. Some are redundant, and I can use some of the others for multiple functions. We might get her down to six leads.”
The young doctor looks professionally skeptical, but he is pre-empted by the old fool, as I chime in, “Yes. Less is more. Let’s proceed.”
Leah cannot take initiative without approval from a “superior,” who gives me the look and follows up with conviction that I am now putting my wife’s life in jeopardy. I’ve heard it before in many forms. He is trying to close the deal on guilt, so that we may move beyond our intuition and instinct to data-based protocol proven effective to within four percent margin of error.
“You can have your angiogram,” I tell him, “But later, after she has a few hours or maybe a day to regain her composure.” I will not tell him that the numbers are compelling or that I am driven solely by instinct. You give these guys an inch, next thing you know it’s the miracle mile, bring on the defibrillators.
In minutes Rachel is relieved of six of her twelve leads. Leah strips her down and removes big patches of postal tape smothering her pores, along with patches of congealed wound dressing that look like dirty glue, maybe two square feet from Rachel’s chest, back and arms. To my amazement, Rachel sits up with a smile. “I want this stuff off my head. It’s really closing in on me.”
“Okay. We can do that,” Leah chirps, which brings further relief to Rachel but chills me with anticipation.
“You’re going to take the bandage off?” I ask.
“Yeah. We don’t need it. It’s only on there so you won’t get scared.”
“Yeah, well . . .”
Leah deftly unwraps the battered head. I reach again for an immovable smile and hold it there, because I am scrutinized like a mirror. “Tell me,” she says. “What do I look like?”
Her head is shaved on the left side. A horseshoe-shaped scar runs from the top, center of her forehead, back and around and down to just beside the left ear. The scar is about ten inches long, just as the doctor had advised. Zigzagging a tight pattern around the bend are fifty-six stitches. I shrug. “You look like you. What are you supposed to look like?”
She frowns and demands, “Tell me what I look like!” I see the monitor as her pressure and pulse climb ten points in the next two seconds.
“You look like Queen Elizabeth with a face lift by Dr. Frankenstein. What difference does it make?”
“Give me my mirror. I want to see.” She is quickly weak and fragile, her voice quivering.
“No, no. Why bother yourself? You had surgery a few hours ago. Let it rest.”
“Give. Me. My. Mirror.”
Fortunately she has only a two-inch compact, so she can’t take in the full gore. The wound has oozed what appear to be four or five egg yolks. Leah assures me this is only more suture dressing. She removes most of it, peeling it off. Worse yet is the steel spike with more plastic tubing coming out the top of her head. Nurse Leah explains, “This measures brain pressure. We call it your antenna.”
“It looks more like a dipstick than an antenna,” I say, hardly intending to compound the difficulty, but I feel difficult, more so than usual.
“Yes, well, antenna sounds nicer. We can get rid of it in seventy-two hours. You’re doing unbelievably well.”
Rachel looks pained and incredulous. “I am?”
“Are you kidding? You’re awake, talking, moving around.”
“I feel better with that stuff off. But I don’t feel good. Look at me. I want the rest of this stuff off me.”
“You will have it off. Every last bit and soon. I can take this one off, too. You’re not even draining.” Leah fiddles with another lead, as if knowing precisely which strand of spaghetti wants attention. This one runs to the left temporal lobe or the back end or somewhere in the tangle. I don’t ask what could be draining, nor can I watch too closely as another plastic check valve on the end of a turkey baster is pulled from a soft area of the skull.
“Yellow matter custard,” I murmur. “Bleeding from a dead dog’s eye.”
“What are you saying?” Rachel gasps.
“It’s just glue,” I say. “And a distraction. You remember the Beatles’ song, I Am the Walrus. Coo coo catchou. Everybody smoke pot. Everybody smoke pot.”
“You need a CAT scan,” she says.
Nurse Leah leaves with the mess. Rachel preens hopelessly like a cat after a losing fight, smoothing here, straightening there, but failing to hide the terrific beating she has taken. I take the opportunity to
explain the need for an additional . . . well, er, uh . . . procedure. What we need is not a CAT scan for me but one more angiogram for her, but not today, or at least not this morning, so she can have time to rest. And after that, we are honestly and truly on the mend, no more procedures no matter what. And that’s no shit.
“Let’s get it over with,” she says.
I turn to tell the head neuro to hurry up or I’ll sue, but I check myself, my humor is so often ill-advised and in this case it feels wrong to me too, which may be grounds for optimism on seeing the light at last. But what light can possibly deny a sense of humor?
This question must wait as I remember our old friend Stuey outside. I re-enter Rachel’s room to say that Stuey is here to visit her.
“He’s here?”
I nod.
“I can’t see anyone like this.”
I feel foolish, bringing guests to see the gore and prolonging the inevitable angiogram. I think I should have slept late.
“He just wants to say hello.”
“No. I’m not ready.”
I walk out and tell Stuey she’s not feeling well and doesn’t want company. He understands, asking gently if she’s doing well. “I think so. It’s hard to say. She’s depressed. And pissed at me.”
He laughs. “You just have to splain it to her.” He wants to know if I want to join him for a cruise around town, to check a few things out. I tell him no, I need some rest. I’ll hang out here for a while. He assures me that hanging out here is cool. He’ll call later. Maybe we’ll do something.
I find Leah and tell her we can proceed anytime with the angiogram. She says we now must wait until this afternoon; the morning schedule filled up. I don’t care, but I wonder what other industry enjoys such a market response. Why do they press so urgently, when another customer is ready? Well, I never doubted the sincerity of the place, I just don’t take to a process so critical to my future but that has no place for my thoughts.
Back in the curtained space Rachel is again napping. I sit and stare. The curtain soon opens on a food server. In the chafing dish is stuffed ravioli in smegma sauce with fat globules drifting in the littorals. I only think this. I don’t speak. I don’t have to: Rachel opens her eyes and nearly swoons. I cover the dish and set it out in the hall. She says she couldn’t eat if she had to. She encourages me to eat it, so it won’t be wasted. I mumble that we must waste it to keep it from wasting me. Her eyes close on my clever retort, and in moments she’s sound asleep. I ponder the relative character of waste. She’ll have to eat soon.
Brainstorm Page 16
