Voices from the emergency room

Across the hall:

Inaudible. Angry.

"Look! You can't talk to the staff like that!"

Inaudible. Still angry, angry and gruff.

"Look sir, I told you. We've given you your drugs, and that's it. You can't have any more."

"Well I shou... should! I'm in here, an'... an'... aleast I'm not out there! I came here!"

"But you can't talk like that here! You're abusing the staff!"


This nurse is getting loud now. It's night shift and all the nurses are men.

"Whul, all I said was f---!"

"You can't say that to the staff!"

"Well scheeez, Imen pain! Imen in here... Imen in here... I juss sed I's in f---'in pain! Thass all I sed!"

"WE GAVE YOU CODEINE. NOW YOU DON'T GET ANYMORE. IF YOU CONTINUE, YOU'RE OUT ON THE STREET, UNDERSTAND?"

"Iz not henuff! C'mon!"

"You get what you got."

"C'monnnnnn!"

"I'm leaving. If there's any more abuse to the staff, I'm calling security."

The nurse stalks off, grumbling to other staff.

Eventually he relents, the guy gets his codeine. Keep the peace, I suppose.




From under the curtain to my right:

"So you're having heart problems?"

Prim, old lady. Proper British accent. Timid, frustrated, tired, unsure, doesn't want to impose.

"Yes, oh yes, sometimes it gets very tight.. right here."

"Alright, you have previous history of angina?"

"Oh, yes dear."

"Any other symptoms that accompany the chest pain?"

"Well, occasionally, I get a bit of a cough. But it's a silly cough."

Silly cough? I think.

Yeah, we treat that with hilarium.



From under the curtain, later, a lady expounds her tale of woe.

It's a polymorphous account, editing and mutating to extract sympathy from the various doctors and nurses who visit. After spinning her sixth tale, she breaks out the coup de grace to a young doctor who doesn't seem to be buying it:

"But I'm coughing up stuff! GREEN STUFF!"

The doctor parlays back, brilliantly:

"You smoke, right?"


This is what I listen to from midnight to three in the morning.

These are the people filling our emergency rooms.

Bi-Lateral Pulmonary Embolism

Whirrrrrrrr.

This room is large. It's quiet, except for soft humming, and bleeps from a computer console. At intermittent moments, the console emits a soft chirp that's almost musical. A technician, female, in her fifties, in a burka, stands in the corner fiddling with controls.

The walls are beige, the machine is white. It's a cage, twelve feet high and more than that wide, with racks and rollers that allow large scanners to float over a long stretcher in the center of the room, where I lay. The is the VQ scan machine.

Whirrrrrrr.

The machine coasts over me. Heavy-looking apparatus comes with inches of my head.

"Breathe deep for three minutes. Don't stop breathing. Deep breaths."

She places a plastic hose in my mouth.

I inhale, breathing radioactive isotopes into my lungs. These have a half-life of six hours. Hear about the controversy on the news about the nuclear reactor being shut down in Ontario? The one the government said would create a medical crisis because it supplies half of the world's supply of medical isotopes? This is one of those medical machines. I'm the one who needs those.

Whirrrrrr.

Coast, scan, coast scan. Listen to my own breathing.

Bleep. Whiiirrrr. Bleep.

"And we're done."

She helps me off the stretcher, back on my wheeled stretcher, and sets my in the hall. This part of the hospital is dead silent, and dark. Because it's the weekend. It's an unsettling change from the noise and pace of the emergency room I was just taken from.

"So... what kind of radiation is this?"

"It's less than you would get from a chest x-ray. Don't worry."




Let's step back 24 hours, to the trauma room.

It's a blur of action. A tech rushes in and takes blood. They want to check my hemoglobin level to see if and how much I've hemolized.

A student nurse sticks me with a IV in my left arm, the only other good spot on my body to draw blood. It hurts like hell and bleeds all over the side of the bed. This is just in case I need an emergency transfusion. The ambulance team already got my right arm, so who knows where the techs will draw from now. A mobile x-ray team wheels in a takes a snap of my chest in less than thirty seconds.

The blood results are back, it hasn't even been ten minutes.

Doctor Hamilton walks in, shaking her head.

"98."

Mom, Vanessa, Me, Hamilton. Our collective jaws drop.

This is exactly what it was when I left. I'm not hemolizing.

"We're thinking it's a clot."

My mind fuzzes. The said something about this prior to surgery... what was it? I can hardly remember.

...I might get a clot in the vein along my pancreas, beside where my spleen was. But the likelihood is a fraction of percentage. Wait... I'm on thinners! I've been in blood thinners since before surgery!

"We'll send for a CAT Scan or a VQ, whichever is available first. That will tell us."

There's nothing else for Hamilton to do. They ship me to emergency to wait for a bed.

Sitting in emergency, I find out that everyone at church was told I'd relapsed badly and been driven by ambulance to the hospital. Great. Then my friend Chris and his wife Jody jumped in his car and sped into Edmonton.

My mom meets him in the emergency waiting room, and comes back to see me.

"Chris is here."

"Really? Send him in!"

"They won't let him 'cause he's not family."

"What?"

"Yeah, he's really shook up. He was shaking and crying."

I'm confused and touched. I don't care that much about my health.


Chris will later come over for dinner after I'm out of the hospital and tell me about that day:

"I was in bad shape. I was driving crazy."

Chris is an engineer who forensically reconstructs car accidents. Chris also drives like an engineer who reconstructs car accidents and looks at photos of people who were involved in those accidents.

"Yeah, I was just thinking about you, and driving, and praying and stuff, and the thought struck me, 'Oh God... I need to have more beers with him!"

Brotherly love works in funny ways.



In emergency, Miles, my father in law, visits for a while, and leaves. He's not doing much better than Chris was. Really, I'm doing fine now. I think.

The clock strikes ten, and my mother leaves.

I'm an expert at this now. I wheedle a sleeping pill and an additional pillow. I convince the nurse to take off my yards of cables and monitoring equipment. I turn, position, don't disturb the IVs. Trust the sleeping pills. Ignore the yelling outside the curtain.

Sleep.

The Ride

"We'll go straight to the U of A. It's going to be busy in emerg."

"....yeah."

Gasp.

This has gotta be hemolysis.

Wait. Hemolysis doesn't act like this.

Gasp.

Blood levels didn't change after surgery... I didn't change my steroid dosage. Nothing could have gone downhill that fast. I've been out less than a day.

Gasp.

Vanessa and I are speeding towards Leduc. I start to sag, sink in my seat. My vision is swimming. I gasp just to get air. My head falls to the window. This is worse than a low blood level. I don't know what this is.

"Screw emergency. Let's go to your mom's and call an ambulance."

We get to my mother's. Within thirty seconds of the phone call, we hear sirens. The ambulance parks on the road, three paramedics emerge, bring the stretcher. I'm helped out of the car. At least the neighbors will have something to talk about. I manage to stand, and I'm piled onto the stretcher and into the back of the ambulance.

My mother calls the on-call hematologist at the U of A.

Liam, looking out the front window of the house, waves excitedly at the ambulance with the flashing lights.

I'm stuck with an IV and gravity-fed saline. I'm given oxygen.

"So, what can you tell us?"

"I was just released from the U of A. I recieved a laporoscopic splenectomy for auto-immune hemolytic anemia. It looks like I'm hemolyzing again."

Insert medical history. Take me to the U of A, please now.

The paramedics, normally confined to taking patients to the nearest hospital, receive approval to transport me to the U of A. Off we go.

Miraculously, within moments I'm feeling better. By the time Vanessa takes a seat in the front and we drive off, I'm having a brisk conversation with the female EMT about her latest practicum.

I chalk it up to lying down. Reclining. It's gotta be the oxygen. Maybe. The saline? This is mystifying.

We get to the U of A. The paramedic looks out the window:

"Uh oh."

"What?"

"We're offloading in the parking lot."

"What does that mean?"

"It means it's so busy, we can't even back in. Like, ten hour wait busy."


My mind blanks. Ten hours in an emergency waiting room?

I'm wheeled in, give my history. We park next to a row of other paramedics, beside other stretchers... alongside a waiting room packed to the gills with coughing, moaning, silent, angry, disquieted people.

In less than five minutes, I'm in a trauma room, being stared down by the same hematologist that discharged me less than a day ago.

Dr. Hamilton, you look very concerned.

Home

I'm staring at a plate of curried chicken. My mom stopped by with tupperware and left hastily.

The light is yellow in my dining room. I sit at the table. I'm glad for this food. Not a day ago I forced down gummy, lukewarm pork and tasteless rice from a hospital tray.

At this juncture, homecooked food is not just a luxury, it's an indispensable therapeutic necessity.

I eat.


I don't really remember the ride home. I was in the car, and Vanessa stopped to get my prescriptions. That's all I really remember.

When you first leave the hospital, with all it's dank body smells, the endless pages echoing through the halls, the pulsing of the IV pump and the sickly food, the inclination of your senses is not so much where you are at the time, but where you aren't, namely, at the hospital.

But now I'm here, home, and it's 7pm. My gladness manifests in exhaustion and appetite.

Liam is also exhausted, out of order. He's been displaced at grandparents houses for over a week. For all their love and care and endless doting, the grandmothers can't replicate the routine of home and family. He'll take a while to get back in his toddler groove.

Vanessa, having carried the burden of a sick spouse, long commutes and a first-trimester pregnancy, is just as tired as both Liam and I.

I gobble my food, and bed finds us all at 8pm.

Before sleeping, Vanessa and I talk.

"You know, even if I need another transfusion, or if something else happens, I don't care. At least I got one night in my own bed."

"Yeah, you're right."

She's hesistant. But I'm less hesistant. I'm here, and not in the hospital. Good enough, one step at a time.

The bed is unspeakably sublime. I stretch out under my comforter, feeling the flannel sheets, the forgiving mattress, the warmth of my wife beside me. Delighted that my feet fail to find a footing of molded plastic.

I pop a couple of T3's so I can sleep with the slight burning in my midsection at the area of the stitches.

I sleep in fits, waking during the night several times. Coming cold-turkey off a steady diet of sleeping pills is not conducive to perfect sleep, but it's good enough. A few false starts and I drift off, wrapped in a cocoon.

I'm dizzy when I wake in the middle of the night. My calf hurts. I shrug these things off.

I wake in the morning and I'm dizzier. It's Sunday.

I'm just pushing myself a little too much. These stairs are beating me. Sit on the couch, no big deal.

My heart pounds.

Vanessa, at the kitchen table, lays out my medication, checking off a chart that she has created for this purpose.

"OK... so... come take your steroids, and your antibiotics."

I rise slowly from the couch. One foot in front of the other.

Gasp.

To the kitchen table. I sit.

My vision swims, and I barely get my pills in my hand. I'm hanging onto the table now. I swallow the pills. I need to lie down.

Something's not right.

Insomnia

Finally, I struggle out of bed. Struggle is a strong word.

I wince, roll, shuffle. I unplug my IV. I wrap my gown around me and make my way out the door.

The night nurse crew is still out. Some of them are reading magazines.

"Uh... hey. I haven't slept in forty hours. Really. I'm just out of surgery, and I need sleep bad. Please. I just need to sleep. Isn't there anything you can give me?"

Four pairs of eyes stare at me blankly.

I look terrible, I know. I smell worse. I just watched a wall clock turn from 10 P.M. to 7 A.M.

One pair of shoulders shrugs. I bite my tongue and breathe slowly. Four hours prior, I was given an IV dose of Solumedrol, which pins your eyelids back with violent force. No sleeping pill available.

"Really. Is there nothing?"

I'm clearly agitated.

"We can page your doctor."

More agitated.

"The doctor responsible for my care is Briesboit. I just heard Stars land. I'm not paging him for a sleeping pill. We both know He's operating on some traumu case."

"Maybe we can get you something tomorrow night."

Tommorow?! Are you @%$#! kidding me? When the hell am I going to be able to sleep?! Tell me! I feel like I'm mainlining Redbull!

Shrug. Back to the magazine.

Nothing sets your teeth on edge like this. I give up.

Turns out if your doctor forgets to allow you a sleeping pill or a tylenol, you're not getting it. And there is little worse than not being able to sleep in the hospital.

Tough luck.


I manage a shower, and Vanessa shows up. This calms me down. I manage an hour of blissful unconciousness, and that's it.

Doctor Briesboit shows up later, and I expound my tale of woe. His solution? Send me home. I've been here nine days. Nothing makes a man sleep like his own bed. I like the cut of his jib a little more.

I haven't dropped a single point of hemoglobin since my surgery, so that looks positive, to say the least. The spleen worked. It worked.

However, Wetaskiwin is not so great; I'm over an hour away if I start hemolizing again. He's concerned.

I don't care. Send me home.

Briesboit calls the hematologist and suggests that I leave. Within minutes he writes discharge papers and prescriptions, and sets them on my table. I stare at them like they're Christmas presents. All I need is the OK from hematology.

And three hours later, when Doctor Hamilton does her rounds with an intern at her side, that is what I get.

Get me outta here. This is over with. Home cooked food. Oh, God, home cooked food. Oh, my bed. I won't have to kink my legs to fit. I fit in that bed. My clothing. My couch. My house. My family.

This is over with.

Right.

Introspection

I never really cried in the hospital. Stress never overtook me - I don't think I had the strength up until now for much of that. I took one day at a time, tried to act chipper for my friends when they showed up, and generally treated the hospital staff like I would roommates. None of this really got to me.

I worried, but hey, that's a byproduct of anything involving near-death. So give me a break on that front.

I don't cry a lot, I don't cry for long, and I get misty at weird things - not weddings or movies or the like, but small things that touch me at strange moments that others around me are standing clear-eyed and stolid. Maybe an existential crisis of infinitely small proportions, or thoughts that touch a strange point in my memory. Anyway.

Now we backtrack slightly.


For the three-plus hours that Vanessa and my mom waited for me to emerge from surgery, they sat in a waiting room, with my bags, in exodus from my room in hematology in order for the hospital to sally forth another patient.

My mother was approached by a man named Gary Garrison. Gary is a part of the "Artists on the Ward" program, a group of volunteers who bring paint, prose, poetry and song to the hospital for patients. I'd heard of the program on posters in the halls, and seen paintings signed with the logo, but had never given it a second thought.

He sat down and introduced himself. He asked some questions.

"So, what are you here for?"

My mother explained in cliff notes my condition and where I currently was.

"What is your son like?"

Day job. Family. Musician. With a day job. New kid. Mortgage.

"So how has your day been?"

She began to expound her stress.

"No. How was your day? From the start. What did you see this morning? What did you notice?"

She told him that she had gone out to her van early in the morning to go to the hospital, when the sun was just rising. There had been small drops of ice scattered on the windshield from freezing rain. And when she thought they would defrost, they didn't, and she drove through a haze of reflections and twinkling headlights, unable to remove the ice.

What lead her to tell him this, I'm not sure.

He thought about it, pulled out a notepad, and began to write. He wrote in silence for about fifteen minutes. Then he handed the page to my mother.


Back to urology.

It's my second day out of surgery. My family has come to visit, but I'm too tired to entertain them. They take their cue and leave. Just my mother is there in the room with me.

"Here. This guy sat down next to me in the waiting room when you were in surgery. He writes poems. He wrote me this. It's pretty cool, we just talked about you for a while and he wrote it in like, less than a half hour."

She gives me the page. I sit in my bed, still exhausted from the effort of eating.

I never really liked poetry, and even after studying and appreciating some in school, I'm kind of suspicious. My teacher always said that good poetry was a dangerous medium in literature because it bypasses logic and intellectualism and goes straight for the emotional human core. But I'd never really felt that about any poetry. Presently, I brace myself for bad poetry, as is my instinct.

I read the page.




The Singer
by Gary Garrison

Anxious, bright, angular sunrise
glowing gold street poles
random rainbow crystals
scattered across the windshield
Bending morning light into wondering
if he'll be well enough
for the splenectomy
if that rebel organ is the cause
of his blood destroying itself
if he'll be strong enough
to lift his guitar and his voice
to give him one good reason
to turn right back around
to raise his own son
to mentor his own grandchildren
to keep writing songs until he's 90.



I put down the page. I pause a half second and glance around the room, at the morphine, at the sink, the IV pole, my spent breakfast tray.

I cry.

Every ounce of Prednisone, Imovane, Ativan, Benadryl, Tylenol, Colace, Gravol, Heparin, Pantaloc, antibiotics. Every shot of every drug they pumped into me to stop the spleen, help my immune system, kill my immune system , counteract that drug, keep me alive, force my body into obeying like a marionette...

...comes pouring out of my eyes.

It burns like hell.

Chemicals running down my face as I see Liam. As I see Vanessa. As I see every friend who offered me their blood. As I see my job, my house with the stupid slanted floor. A haze of molten frustration, despair and hate at a body I can't understand and couldn't help to save my life.

It floods out. Spent.

I guess Gary did his job.

The Urology Ward

"Rrrrrr... ssssssss. Rrrrrrrr...sssssss."

An anaconda is eating my thighs.

"Rrrrrrrr....ssssssss."

The leg squeezers wake me up at 4 a.m. They won't let me go back to sleep. In fact, I won't sleep for another forty or so hours. To paraphrase Chris Rock,

"There is no sleep in the urology ward."

But that'll be ruminated upon later.


The urology ward is a strange place. Medical posters on the walls featuring diagrams of genitalia and information on avoiding kidney stones. Patients ambling down in the halls, asses hanging out of ill-tied, flimsy gowns, clutching IV poles, toting around plastic boxes filled with their own urine. It's like a Terry Gilliam movie.

Truth be told, I'm one of them. And as I emerge from my drug-addled haze, I realize I have problems on a two-fold front:

1. The stitches. In hindsight, these aren't bad. The laparoscopic surgery has left me with two small incisions, and two other entry points I would be hesistant to even call incisions; they're more like pokes. The only bad thing? I'm told I need to cough to avoid filling my lungs with fluid that could cause pneumonia. Cough after my abdominal wall was just sliced through? Surely you jest.

2. The catheter. You can't feel it when it's there, in fact you don't even know it's there because it's put in during surgery. However, the Hippie Nurse tells me,

"Aw man, it's gonna be awful. It feels like your intestines are getting pulled out. And then the first time you take a leak, it's gonna burn like nothing else."


OK, I'll admit, I'm truly intimidated. Catheters occupy the bladder in the form of an inflated balloon, and exit through the penis. My mind reels. Guys in general don't like having their parts fiddled with by strangers, and I'm not happy about having this thing out. When the day nurse comes, I ask her to get it over with.

And without describing the scene, it's really not that bad. Turns out the Hippie Nurse was just messing with me.

The day nurse helps me to move around.

"You see, they pump you full of gas during surgery so they can work in your abdomen. Your body needs to squeeze that out. When you walk around the first few times, you'll feel like there's a tremendous weight on your shoulders. It'll subside, but you need to move around. Walk at least three times today. I'll help you."

And she does. Getting out of bed is a new experience: crook left leg; straighten right. Move left leg to right side of bed. Perform half-roll. Shuffle legs to the side, sloooowwwly sit up. Sit on the edge of the bed until heart-rate subsides and head stops swimming.

The first walk is an adventure. I'm now one of the urology patients, ambling awkwardly, clutching my IV pole.

Dr. Briesbois comes to visit, in his usual brisk fashion. When I shake his hand, he immediately turns around and washes in the sink while still talking to me. It is in equal measures a bizzare and oddly appropriate thing for a surgeon to do.

He reports that the surgery was flawless. They transfused me for one unit of blood during surgery " just in case", but there was no bleeding during the actual surgery, which was a distinct possibility. That makes six units of blood in the 24 hours up to surgery.

I'm glad people give blood.

In fact, he thinks I could be out in a day.

A day?

He takes away my Morphine PCM (which I'm glad for later. Morphine slows body functions, including bowel and bladder control. I'm also glad I wasn't heavy-handed with the controller).

He leaves, and later a two-nurse team comes in to dispose of the PCM. They unlock the case, record the levels in the syringe (Does that thing hold a LITRE? Good lord, I only used maybe 5 percent of it!), and flush it down the sink in the room. Ah, morphine in the North Saskatchewan.

While the reassurance and safety of the hospital is nice, the surroundings are wearing thin. I haven't been able to shower for days. I smell like hospital. The food, which seemed cautiously adequate during the first week, is growing odious. I need to get out of here. Yes, please, send me home.

Post-Op

"Nialle? ...Nialle Travnik?"

Light. Eyes close... black.

Again.

"Nialle Travnik?"

Light. Shapes. People. It's quiet here. More light. I feel faaaaaaantastic. I don't care why. Someone's talking to me. I don't care. Eyes close. Black.

"Nialle Kelsey Travnik?"

I'm up.

"It took a little more than normal to wake you up. We were kind of worried."

That's because I didn't want to wake up. Warmth. Warm. Calm. Happy. I've never had morphine before.

I'm in the OR waiting room again. Maybe where they send patients after surgery. Post-Op. Probably. It's calm here. Or maybe I'm calm. The nurses ask me how I'm doing, but I have trouble making brisk conversation. I resolve to relax. This is a vacation, as far as I'm concerned.

I'm wheeled out, out of the waiting room, out of OR. Into my new ward. Vanessa and mom are waiting on the catwalk. Looks of relief on their faces as they stride towards my stretcher.

"How are you?"

"Oh, I'm doing awesome."

No other words to describe it.

I'm installed in a post-op bed in the Urology ward. I'm fitted with "leq squeezers" as I call them, tight leggings that contract and release at regular intervals to prevent blood clots. A nurse puts a black controller with a white button on the top.

"OK, this is a PCM. You can control the amount of pain relief you want. It's morphine, and it will give you a pre-measured dose when you press the button. You can use it every eight minutes. If you're in pain, don't be afraid to use it. That's what it's there for."

Chris and Jody visit. I manage to make conversation, I enjoy having them there. People move in and out of the room. I still don't remember much, painkillers are like felt on a blackboard.

My nurse in an old hippie. He's got long hair and a big mustache.

"Yeah, I worked in palliative care for seven years before this. You know, terminally ill patients. It was great. You think it'd be dark, but it's not. I just left my work at work, y'know? One day I had eight patients die. Yeah. It was just part of the job. Then I moved to the cardiac ward. I was a little too laid back after being in palliative all those years. People would be having these heart attacks, and I'd be like 'Hey! Don't worry! Just go towards the light!" You can't do that in cardiac."

I learn quickly that laughing and fresh stitches are a painful combination. Not that in the first few hours I felt much pain at all.

You tend to hear stories of people drooling after taking a couple of Tylenol 3's.

Everything in post-op comes in bigger doses. A couple of T3's? Done. Advil? Sure. An unpronouncable painkiller in your IV? Some morphine? Anything else?

I press the morphine button and hear Hawaiian guitars. Sleep comes.

Surgery

2 pm. Right on schedule. This is a dream.

I used to be scared of surgery - the thought of getting put under was always a moderate phobia for me. I've always had a slight fear of minding altering drugs, and I hate being drunk. Having a foreign substance heavily mess with my state of conciousness was never my cup of tea. Just a thing, I guess.

A few months ago I got my wisdom teeth out and received general anesthetic, so I guess that took the edge off my fear. Because as soon as I saw the porter walk in with the stretcher, I was ready to go.

Still sick, but not sick enough to process the smell of food wafting from the cafeterias. As they wheeled me to my destination. NPO for only little over a day, and boy did this feel rough. The meds still had theirs sickly edge on me, but the nausea drip the nurse gave me was starting to take hold. By the time I got to the operating room waiting area, I was floating.

Hospitals, particularly the U of A, are tremendously busy. Nurses and care staff eke out time for breaks, dealing overflowing beds, patient and staff issues, and the like. Resident Physicians work incredible hours and are called and paged constantly.

But the OR? This is a different beast entirely. It's quiet.

Few questions, no screwing around. Action, action, action. Not a single second spared. The place is booked so tight that there is little room for error or delay. And a sense of calm professionalism permeating the entire operation. If the hospital wards are like a ride-along with a traffic cop, then the operating room is like watching a SWAT team in action.

In the waiting area, my stretcher is parked in a stall that corresponds to the operating theater. A too-sweet-for-words receptionist greets me. She smiles reassuringly, chats me up, and refers to Dr. Briesbois as "a wonderful man."

Moments later, Briesbois walks by with another OR member - I eavesdrop - he's livid that the people responsible for delivering the operating instruments have sent him the wrong set - for the third time that day.

The receptionist says, "your anesthesiologist will be by soon," like he's the bellhop or something.

When he does come, he's animated, jovial. In keeping with the speed of the OR, he fires off a rehearsed, rapid-fire burst of questions and disclaimers.

"Hey, I'm Dr. Hayes. Do you smoke? No? good. Any allergies? None at all? Have you had general anesthetic? Stick out your tongue. Farther. Ahhhhh. Good. We'll be putting in a breathing tube. Down your throat. You'll be out, so you won't remember it. There's a 1 in 2500 chance we may chip or crack a tooth. You'll probably wake up with a catheter. Great. See you in there."

Within moments I'm wheeled into the theater. It's unnerving. I don't recognize this equipment. It's bright bright, clean clean. I'm staring at the ceiling. Strange - there's a sprinkler system, all with angled Plexiglas guards protruding from the ceiling to deflect the spray away from the operating table. What if I spontaneously combust? That's no good to me then.

I glance around. A team of assistants scurries around, preparing. Still no wasted time. A rubber mask is placed on my face.

"Your oxygen is 96%. We like it at 100. Breathe deep. OK. More. You've done this before. Great! 100."

As soon as I'm strapped down to the table, Dr. Briesbois and Hayes appear. Dr Hayes bends over me:

"OK, we're gonna put some anesthetic in your arm. Did you at least get some photos of your spleen? I mean, this is your last chance. You might want to get some photos. Just in case you miss it."

"Naw... thats... cooo..."

Black.

NPO

*Disclaimer*

If you've had surgery, you are probably familiar with this procedure. It sure surprised me, though.



I stare at the bottle.

"Just don't take it too close to bedtime."

The nurse unscrews the cap, sets in on my bedside cart. I stare at it some more. It's about the size of a small cough syrup bottle, opaque white, and says "Fleet" on the side, with some medical information. It's important that I drink this prior to surgery. Something tells me to wait.

That nurse leaves, and when the evening team comes, I take the bottle, drag my IV pole into the hall and talk to the nurses I trust.

"So... this is supposed to clean me out."

The nurse squints at the bottle.

"Yeah, that'll do it."

"Now be honest with me. Am I gonna have a nice cruise down the Hershey Highway, or am I going to be running for the border?"

They laugh. I even think it's kind of amusing at the time. But really, this stuff isn't that funny. Gech, I'm getting nauseous just writing about it.

I take it like a man, swallow the most foul stuff I've ever encountered, and wait.

Later, Vanessa comes to the hospital room to watch a movie on my borrowed laptop. When the fleet hits, she'll have to lift my IV pole over obstacles so I can get to my... destination. Fleet indeed. There's definitely some fleeing going on.

Meals arrive, less robust than hospital food normally is.

Breakfast: "orange gelatin", orange juice. Tea.

Lunch: Beef broth. Water. Tea.

Dinner: No dinner.

I cheat. My mother hustles in a tray of fast-food sushi, and I ravenously down three salmon rolls. They are the best salmon rolls I could conceive to eat, ever. Technically, solid foods after midnight are a no-no, but it's only around dinner time. And it's just rice. and some fish. I should be OK. I hope.

The next day, I'm officially NPO.

When you're NPO, they put a small red tag on your nameplate outside the hospital door. This means Nothing by Mouth. Nothing. They pump you full of saline so you don't get dehydrated. The real catch is, you still have to take your medication.

It's always the treatment that makes you feel worse than the disease, right? A high dose of steroids, folic acid, vitamins and calcium on an empty stomach - no water - leaves me sicker than I ever been. I give up on using my laptop. The thought of reading makes my stomach turn. When I'm forced to stand to urinate, the effort makes my dry heave repeatedly.

My surgeon, Dr. Briesbois, visits again. He's dressed in OR scrubs.

"We have two surgeries ahead of you. If they go well, you're in today. If they don't go well, or if we have emergency trauma cases, you can eat."

That's the nice way of saying not today, you get to do the NPO thing all over tomorrow.

Uh-uh. Vanessa and my mom pray hard the other surgeries will go well.

After a few hours I finally I relent, and beg the nurses for some relief. Without hesitation, the nurse hooks me up with a medium-level anti-nausea medication, kind of a "Super-Gravol." It works well. I smack myself for not asking earlier. The nurse relents and gives me some ice chips and tells me not to "go nuts."

My pastors come and visit. They bring cards signed by the church. I do my best to look upbeat, but I'm really, really sick, and smell really bad. They pray for me. My appreciation is greater than I can express in this state.

Twenty minutes later, a nurse arrives with a porter and a stretcher.

"You're in."

A Visitor

Now I'll digress, within the story. This is pretty important, pretty hard to write about.

I've been in about a week. While my hemoglobin quivers at the 70's mark and the hematology department waits for an available surgery date, they keep plugging me full of blood, two units a day.

My energy is drained. Everything is slow.

One afternoon, I hear a knock and look to my right, towards the door.

It's my father.

I look to the left, out the window. And that's where I hold my gaze until my thoughts collect.

OK. Don't get excited. Just be polite. Just keep your heart rate down. Deep breaths.

I look back to my right. How long did I look out the window while he stood there?

"Come on in."

I'm cordial.

He enters and sits. He looks uncomfortable. I'm not sure why I feel bad, he should be. I don't remember much of the conversation. I'm formal. He asks about diet, suddenly concerned about me. Great. To little too late after "too late" was too late. He makes small talk. I make small talk back. I'm shocked at my emotional detachment. I really don't feel anything for this person. I've cut myself off.

I even remember the day I cut myself off.

It wasn't when I realized for myself, at 16, that seeing your son twice a year wasn't normal.

It wasn't even due to events a couple of years into my marriage with Vanessa. She, curious, contacted him, and a few months later he walked out on his second wife, my half-sisters and his business for another woman (disclaimer - when you're getting your information from an estranged second wife, things get distorted. But my sisters got the same treatment I got).

It wasn't even when I got the first Christmas card, almsot three years ago, from him and his new girlfriend, addressed to "Nialle Antypowich," which I tore up and threw on the floor in disgust and rage. I was pretty angry even still then.

No, It was two years ago, when I got the second Christmas card addressed to "Nialle Antypowich." I eyed the thing warily, sighed, and wrote "My name is Travnik" on the card. Then I sent it back to him. I hadn't heard from him since.


"Open the card, please."

Again, I sigh inwardly. I open it. There's some nice platitudes scrawled on the inside. I have no interest in reading these. Let's get this done.

"Your grandmother wants to see you. She's a great grandmother now. She wants to see her great grandchild. If that can happen, think about it... and you know, if you and I can... talk, that would be good."

Can't this guy recognize his own burnt bridges? Astounding.

I mumble something.

I'd love to deal with this. I really would. I don't have the blood right now. I don't want to scream, or give him a piece of my mind. I don't want to humiliate him or put him in his place. Forgiveness is a nebulous thing, and when you've forgiven someone but still clearly can't trust them, It's... awkward. What else can I call it?

He needs to know he doesn't have a place in my life. He needs to know it is not his grandson. And the rings that he gave my mother and she in turn gave to us because we were short on cash when we got married? He needs to know his daughter-in-law threw them away after she got to know him.

I can't trust. Not because it hurts, or because I'm scared. Because it's impossible. Too many burnt bridges. Bridge after bridge after bridge.

He leaves, I'm still polite. Detached. Later in the hall he'll lambaste my mother about "negative energy" being somehow connected "separating a son from his father." He apparently thinks this is connected to my illness.

Did I cease to be an adult? Do I not have a family? He's still dealing with my mother in proxy, like I was twelve.

Then he leaves. I'm not sure I'll see him again.

And I'm ok with that. Too much to deal with here.