Whipsaw Days (Part 3)

First, a riddle that arrived on a postcard from my brother who is spending the year in Prague with his family. (Lots of wonderful writing and photos at the blog, written by my sister-in-law Kate.) The riddle itself is from my eight-year-old nephew Ben.

Q: Why can't you hear a pterodactyl go to the bathroom? (Answer at the bottom of the post.)

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[You should read Part 1 and Part 2 first.]

[Wednesday night, February 16]

There is a knock on the door. It's one of the ENT doctors. I need to have surgery. Tomorrow? No, right now. That explains the gurney outside my door.

The biopsy they took from my mouth in the afternoon did indicate that there was a fungus involved. Too soon to know what kind of fungus, but there is one in particular that they can take no chances with, the one that keeps the ENT doctors up at night until they rule it out or eradicate it. She describes it as "very aggressive." I later learn that this means "can kill you in a day," but "very aggressive" provides plenty of dark room for the imagination.

The doctor offers to speak with my wife. I think it's better if Jan hears it from me, so I put off the call while I learn more. The plan is to cut away the inflamed tissue on my upper palate to see how much fungus is hiding underneath it. They can't say how much tissue they will need to remove or how long the procedure will take. If the fungus appears to be contained within the inflamed tissue, then they're done once that tissue is excised. If it has spread deeper into the palate, they will remove more. If it has spread to the teeth, they will remove teeth. If to the jaw, remove part of the jaw. (There would be reconstructive surgery later to replace whatever gets removed.)

Since they don't know how much they're going to do until they start doing it, they can't say how long it will take. I might be back up in my room by 3 a.m., I might be recovering in the intensive care unit at 8 a.m., I might still be in the operating room at 8 a.m. It all depends on what they find when they make their first cuts and how far they have to go to feel that they have gotten it all.

Time to call Jan to let her know that I may not be in a position to give her the daily morning "I'm awake" text/call, and why. She is on my phone's speaker as I review the plan, with the doctor present. As I start getting to the removal of teeth, Jan indicates she's heard enough detail. Jan gets a phone number for being able to contact the ENT team, and they get her number in case they need to contact her.

I say goodnight to Jan, but a far different goodnight than she deserves on her birthday. (Sorry, Jan.) I know she's not going to sleep tonight.

I'm sitting on the edge of my bed, putting on my slippers, head bowed, shoulders rhythmically convulsing.

"I know," says doctor sympathetically, "it’s a lot to take in all at once."

But I’m not crying. I’m laughing (ruefully) at the absurd perfection of this ending to the day, with all its ups and downs. Of course we needed one more twist to make the day complete.

Transport has been waiting outside the room, patiently. He greets me by name with a Mexican accent and a smile. I prepare my room for this unexpected absence: put away attractive small items, lock up laptop. Once I’m on the gurney, he positions himself so he can talk with me, which he does. Talks about how much he loves his job, loves learning about the patients he moves, likes to check in on them after their procedures. He was happy that he was stuck at the hospital for 5 days during the blizzard, that’s how much he loves his job. He is from Acapulco. I tell him I have visited Acapulco, "y yo vivía en México cuando yo tenía quince años." "Ah, we must talk of Mexico and Acapulco. Good luck, Mr. Seeley, and I will see you again." That is how Transport is supposed to work. For the duration of the trip, I feel less stress than I felt just before and much less than I am about to feel. He is a healer.

"Welcome to the OR Recovery Room."

"Oh, finished already? You guys are very good."

No, the recovery room is also where we prepare for the surgery.

There are some introductions, who’s going to do what. A few minutes in they realize I’m under an isolation order, which means they all should have on an extra layer of stuff -- gloves, masks, smocks -- before I came in and potentially contaminated them. “Wasn’t that information in the order?” “There was no order.” “How can there not be an order?” It’s kind of too late, since I’ve already been wheeled in and some have already interacted with me, but they scramble to put on the gear. Not building confidence.

It feels like a hospital TV show cast – loose banter among staff. More serious than Scrubs, less intellectual than House.

“Is this your first surgery?”

“Yes.”

(Someone yards away) “Vir-gin!”

I have received a bunch of platelets and blood already today, and I’m going to get more. My platelet counts have hovered around 10, and you want at least 50 to feel comfortable cutting someone open. I’m close, but more is coming.

A doctor tells me the side effects of a medication I’ll be receiving: shakes, chills, sweats, kidney malfunction. Also, a risk of anesthesia so close to eating – unavoidable, since this is an emergency – is vomiting into your lungs and then contracting a deadly pneumonia. But they have a way to minimize the risk by pressing on the voice box as I'm going under, so I shouldn't be alarmed if I feel that happening. It sounds very uncomfortable, as I'm picturing that they are manually collapsing my voice box, but they demonstrate and I realize it's not something I need to worry about.

For the first time since my diagnosis, I have a Mortality Moment. They're going to be slicing open my head, from the inside of my mouth. The surgery could go wrong, and I could die. I could vomit into my lungs, and I could die. The surgery could fail to get all the fungus, and I could die. I might not leave the hospital alive. The OR might be the last thing I remember in my life.

But probably not, and the moment passes.

I sign a bunch of waivers. There's a lot of fancy words about risks and side effects, but it all boils down to, "Do you want to live?" "Yes."

Off we go to the OR. I am torn between wanting to see my surroundings, for documentation, and wanting to close my eyes and go to my happy place. Oh no! I haven’t picked a happy place! I’m flipping through mental brochures at the Happy Place Travel Agency. In a hammock on a tropical beach. Floating in a magical cenote in the Yucatan peninsula. Basking on the rocks at the top of a New England mountain. Hurry! Pick one! The building is on fire and is about to collapse!

Not working!

I try a smiling Jan gazingly lovingly down at me. It's corny, but there are pink and red valentines scattered behind her. It's powerful stuff, and it is briefly calming. I think, not only is she helping me now, but I'll be able to tell her afterward how gazing up at her sustained me through the surgery. "You're having surgery?! What are they doing to you?! Oh, God, please don't die!"

NOT WORKING!

I have no idea where it comes from, but now I see what I would see if I were riding a bumblebee circling a foot or two over Moroccan mosaics. Rhythmic, sinuous, infinite -- not bad for a last-minute happy place entry.

But I’m still feeling those side effects they mentioned: shakes, chills, sweats, teeth chattering.

"So, that medication with the side effects you were telling me about? Have we started it?"

"No, that medication starts after the procedure."

"Oh, so these symptoms are just from fear. Thanks."

"Don’t worry, we have something for that."

The last thing I remember hearing is, “At least one of those teeth is coming out.”

Fade to black.

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Q: Why can't you hear a pterodactyl go to the bathroom?

A: Because the "p" is silent.

Read Part 4