Four days in hell and a shot of heaven

Thursday morning before the long weekend, I woke up with a touch of nausea, nothing bad. I had a simple breakfast of toast with apple sauce like my grandma would sometimes give me and went to the studio. I painted a little but went home early because I didn’t feel strong and my stomach was bloated hard. I looked like an anaconda that had swallowed a pig.

It escalated into pain and I cancelled a 7 pm meeting. Bunny took me to the emergency room about 7:45.

The pain continued to increase and even though there were less than 20 patients in the waiting room, I didn’t get seen for several hours. I was writhing and moaning and went into convulsions three times from the pain, but no doctor. I asked Bunny to kill me. I’m sure he considered it. An administrator told me if I were going to have an attitude, she could just leave me there and not call me in. At one point, an elderly Mexican man told another attendant to take me before him. Everyone was concerned about my condition but the staff. Bunny stayed with me and Jeanne came to the emergency room and stayed awhile also.

It was difficult to draw blood because I was so dehydrated; I hadn’t had anything to eat since breakfast or drink since 4 pm and that was just a sip. And I had vomited a couple times.

I asked the woman drawing my blood what was being tested. She said the doctors needed to know if I were diabetic or hypertensive. I said they could ask me.

Remember, the most common blood test is the white blood cell count which indicates infection.

I was told several times I would be seen by a doctor when there was a room for me. This continued until a nurse took pity and put me on a gurney in the hallway. It could have been done earlier. About 1 am, I got an intravenous medicine for nausea which didn’t work. It was another hour or more before I got a dose of morphine. No antibiotics were started.

In the meantime, I was given a CAT scan. The child who administered it told me to jump up on the table. This was before morphine was given to me and I was still doubled over in pain.

(Side note: December 1, 1989, I was in a car accident with my parents out in the desert an hour from Barstow –that means it took an hour for an ambulance to arrive to the scene where we hit a semi-truck head-on and rolled into a ditch because the axel of our car broke, an hour to load us into the ambulance, and an hour to return to the Barstow Hospital. Then, I had 18 hours on a gurney in the hospital hallway before I received morphine. When I was sent for an x-ray, the child there administering it said, “Hop up on the table.” I said, “I have a broken back.” He said, “You don’t have a broken back until a doctor says you have a broken back.” I said, “That is a lie.” It happened that I had three crushed vertebrae, a broken foot, and my skull was cracked and glass remains in my head to this day. Years later, I went to an emergency room and said to the triage nurse, “I have kidney failure.” She said, “You don’t have kidney failure until a doctor says you have kidney failure.” [It becomes obvious that standardized, lacking-in-compassionate responses are a required class in medical school]. Again, I said, “That is a lie.” She turned white when my urine sample quite literally looked like molasses.)

The CAT scan was inconclusive and the pixie-of-a-doctor diagnosed a rare gastric disorder (which may still be accurate, nobody has followed up on that). She said the appendix was fine. I suggested it was a congested ileo-ceacal valve. She said that the ileum was somewhere else. She ordered the nausea medicine that didn’t work then ordered another that did. An hour after that, I got my first dose of morphine. It didn’t take the pain completely away but allowed me much relief. Two hours later, I got a smaller dose of morphine and was able to nap a little on the gurney in the busy hallway. But the pain never left completely.

I was discharged at five in the morning and Bunny took me home. Nine hours in the emergency room and only temporary relief. Nothing was fixed. Remember, no antibiotics.

I slept a couple of hours and showered and called Jeanne to take me back to the emergency room. I didn’t feel bad (I didn’t feel great) but was told to follow up with the doctors in the ER. I thought we would run in there for a minute then have lunch.

After sitting in the waiting room for three and a half hours, the pain became incredible again. The blood draw nurse recognized me. The case manager recognized me. Both were kind. Everything else was as if starting from zero, even a new ID number that didn’t link to the file from the day before; the last ID bracelet was cut off me and replaced with a new one. The only exception was that when I finally got into the sacred city of the treatment area, I was given morphine much sooner. Then I had the second CAT scan of the day.

A nurse came to tell me the first CAT scan wasn’t clear. I told her I was in so much pain I wasn’t able to remain still. She said the doctor wanted to use contrast for a clearer image. I asked what the base of the contrast dye was. She said iodine. I said I am highly allergic to iodine. It is in my chart. She said I would be given Benadryl. I said I needed to speak with a doctor about that. She said it would be ok, not to worry.

Once, when I was a child being tested for everything under the sun because of an undiagnosed problem –a different doctor/test/hospital or office every other day – a nurse tried to convince me a mild drug would counteract an iodine dye for a similar test. I took the drug because I knew it was rather benign (my mother was a nurse and I was familiar with some medical things) then walked out to the waiting room and told my mother what test was being run that day. And stood back. A Tasmanian Devil had nothing on her and the entire hospital shuddered. The president of the hospital was pulled off the golf course. That hospital is now closed. An oral dose could kill me, an intravenous dose would be unstoppable.

But this time I had to advocate for myself. While on morphine. It was lucky I thought to ask about the substance. And it was strength to not allow her to convince me it would be fine.

The test was run without the contrast dye.

This doctor suspected appendix problems but the shift changed and she told me she would follow up on my case the next day. The results from the CAT scan would be available in 40 minutes, she would inform the next doctor of her ideas. I never saw her again.

At this point, no antibiotics have been administered. Two blood draws, no mention of elevated white blood cells but talk of appendicitis.

Because of the morphine, I felt better, almost normal. The 40-45 minute period of time to get the results of the CAT scan had passed two hours before and not a single person had spoken to me. I asked a young guy who was running around if he would get my nurse. He said he was my nurse. He had been in and out of the room for two hours and had never acknowledged me. I said that my lab results were in hours ago and I was just waiting. My IV was long done and I hadn’t eaten or drunk in a couple days. He looked at me as if he were surprised that I was there in plain sight.

I heard the nurse tell the new doctor my name and to check the results of my test. The doctor was about 15 feet from me and must have heard me speak also. Forty-five minutes later, he still had not come to visit me. Read that again.

I unplugged my empty IV, got dressed, and left the emergency room.

Outside the hospital, I was able to get cell phone reception and called Jeanne to come pick me up. I still had the IV lock in the back of my hand.

A few minutes later, the case worker who had recognized me from the long dramatic visit the day before, came running out of the hospital and shouted: What are you doing?

I said I was leaving.

She said she was going to have to call the police to look for me, my appendix was going to burst and I would die.

I said that that could have happened in the last three hours when not a single person checked on me and the doctor refused to come to the room even when he was asked. That could have happened either of the times I was writhing in pain in the waiting room for hours.

“Please come back,” she said. “I will take care of it.”

She asked the doctor’s name and we walked in together. The nurse helped me back into the useless and ridiculous hospital gown and I got onto the bed. I heard the case worker speak to the doctor. He didn’t move. She then pulled him by the lapel of his coat and dragged him into the room. Seriously.

He said to me, “Your appendix is going to burst and it has to be removed. You could die. We are admitting you into the hospital and will do the surgery tonight.” He turned to leave.

I said, “Stop! You forgot about me and refused to come into this room even when asked. My tests results were back hours ago and you should have reported to me immediately. Especially if I were going to die. You will not admit me nor perform surgery without my permission.”

The case worker said, “He only came on an hour ago.”

I said, “The previous doctor told me she was leaving and was concerned about my case. She said she would update the next doctor and have him discuss the results of the second cat scan with me. And I saw that man right there joking with large-breasted women hours ago. I can see everything from here.”

He said, “Can we admit you to the hospital and perform surgery?”

I said, “You can admit me but I need to speak with the surgeon before I decide about surgery.”

He turned and left. He never walked the 15 feet back into the room again.

I was admitted into the hospital at 1 am, many hours later. As I was being wheeled past that doctor, I asked if I could have water or ice chips. It was beginning my third day without anything by mouth. He said, “No, um, wait, let me see, yes, uh, no!” He thought he was clever, he was making a joke.

I said, “Catheterize that man.” I wasn’t making a joke. I was wheeled to the elevator.

It was a different world upstairs.

The floor was quiet, uncrowded. I had a room to myself. I was settled in by 2:30 am. I met doctors, nurses, orderlies –all were kind and attentive.

One asked about my stay so far. I mentioned the wonderful people who had helped me. Then I mentioned the horrible doctor, the horrible administrator. She asked the name of the doctor and when I replied, she rolled her eyes knowingly and said: “He’s new.”

Intravenous antibiotics had been started during the hours I waited to be moved up to a mostly empty floor. That is what saved me. And the antibiotics were allowing the pain and nausea medications to be more effective. Upstairs, a nurse monitored everything precisely. Every two hours, there was either an IV change, a pain medication check, or some other thing. Every two hours around the clock.

The bed had an intercom where I could speak to the nurse’s desk. It was always answered immediately. If I needed to go to the restroom, I had to be unhooked from a leg massager that helped prevent blood clots (something that happens from being bed-ridden) and the IV had to be unplugged from the wall. Because I was on morphine, I was not allowed to walk alone. As I improved and hydrated, I needed to use the intercom more often.

The next couple days were a parade of doctors and nurses, friends with help and flowers, inedible food.

(Aside: the kitchen attempted to accommodate my diet. But the tofu was spoiled. The other food was not fit for a beast. One meal consisted of a fruit plate, a fruit salad, and a side of fruit! The fruit was fresh. That was the best. The plain, bland oatmeal was surprisingly ok and made me feel cozy.)

When I finally met a surgeon, I was unprepared to find him intelligent, honest, and open-minded. He had not altered the phrase: if you have a hammer in your hand, everything looks like a nail to something regarding a scalpel. He was young, tall, long hair, and a backpack.

He showed me the last CAT scan. He showed me a small stone in the appendix (a less common cause of appendicitis). He showed me the slight swelling. He showed some impacted material. We talked.

I said, “If appendicitis is an infection and if the antibiotics kill the infection, why do you need to remove the appendix?” After a head cold, you don’t need to cut off the patient’s head.

He said, “It’s not exactly the same. But there is something to that. Some people don’t have the appendix removed. Of those, ten percent return to me to have it removed within the year.”

Me: “Then 90% are fine without surgery.”

He smiled.

Me: “I will put you out of business.”

Him: “I will always have plenty of business.”

I’m sure it’s true.

I told him that for once in my life it may be prudent to be conservative. He said that was fine and reasonable. We agreed to wait another day.

During that day, I took no morphine. My vital signs were normalizing. I was reading a book and getting my legs massaged by the bed machine. People were visiting but not too much to be annoying.

I slept well enough. I ate fruit. My mother called to check on me.

The surgeon’s protégé returned to speak with me, to ask about my condition. She wanted to know my thoughts on having the surgery.

I told her that the first doctor had said the problem was not the appendix and diagnosed something else. The second doctor had said it may be the appendix but it was not conclusive. And the third doctor said the appendix was ready to burst and had to be removed immediately. We know one was wrong. He didn’t even start the antibiotics immediately. Well, none of them did.

I also said that when I first arrived, I had told the first doctor that I thought the problem was a congested ileo-ceacal valve.

She was shocked: “How do you know that?” Nobody (a non-deified medical doctor, a commoner) knows that.

I said that that was what it felt like before everything went to hell. I told her that the first doctor said the ileo-ceacal valve wasn’t located there by the appendix.

The surgical protégé said: “They are next door neighbors, practically touching. And the surgeon did see congestion on the CAT scan.”

I said: “I think that is how all this started.”

She mumbled something in the affirmative, her eyes glazed and distant, the wheels in her brain connecting the dots.

When the surgeon returned later and asked after me, I told him I had had no pain medication, was feeling more normal.

He said: “After speaking with you yesterday, I did a little research. You are right!”

(Read that again, you may never hear such a thing from a medical doctor. Once, when I was a younger man, I woke feeling miserable. I could not move and I knew it was serious. I called my mother to take me to the emergency room. I told the triage nurse I thought the problem was my liver. Well, you know what she said… When a young Asian doctor came to attend to me, I said it again. He said without any analysis: No, it isn’t your liver. I asked him to check the liver anyway. He ran a panel of blood tests and when he returned, told me everything was negative –nothing was wrong with me. He started an IV of fluids and told me I was dehydrated. I said I was not dehydrated, my liver was sick. What did the blood work say? He said he didn’t test the liver, there was nothing wrong with it. He asked why I thought the problem was my liver. I said, for one thing, the whites of my eyes are gray. He said they weren’t. We stood next to each other and looked in a mirror together. He could not see the difference in the color of the whites of our eyes. I thought a Chinese doctor may know something about Chinese medicine. I was wrong about that. I said again that I was miserable so he ran another blood panel. He returned to say that, again, everything was negative. I asked what the liver test revealed. He again told me there was nothing wrong with my liver and he didn’t run a test for it. My mother, much smarter than me, said: He has tenderness on the right side. The doctor ran blood work a third time, including the liver, and returned to tell me that my liver enzymes were very elevated but that that had nothing to do with my condition. He said: See, you feel better from the fluids, you were dehydrated. I said: I feel better because you put pain medication in the IV fluids. I could read the label on the IV bag! I took care of myself after that.)

Back to the now and the surgeon saying I was right: 90% of people with appendicitis where the appendix has not burst and are treated with antibiotics have no trouble for a year. (It seems the study followed people only a year. There are too many factors involved to make a study of a longer period of time valid.) If you are fine with it, I am ready to release you.

Me: “Doctor? Yesterday, you told me that patients return to you for an appendectomy when the appendicitis is gone. Why?”

Him: “Preventative.”

Me: “Isn’t that like cutting off your pinky finger to prevent a paper cut?”

Him: “It’s not exactly the same…”

Blah blah blah…

I am home now, surprisingly tired after doing nothing for so many days (except that I was quite traumatized, just the blood draws require recovery. Both hands, wrists, and forearms in a few places are spotted with large bruises. I look as if I am transforming from an anaconda into a leopard), and nauseous from the oral antibiotics I need to take for two weeks. With (decent) food. But no alcohol! (The pharmacy didn’t get the prescription even though the hospital sent it twice. I returned to the hospital in the middle of the night, convinced the security guard to allow me in, went to the nurse’s station on the floor where I lived for the long weekend, and spoke to a nurse who prattled on about how a nurse can’t write a prescription… Language barriers in a place of life or death, ugh. Luckily, one nurse and then another appeared who recognized me and were surprised to see I had returned. And showered! They contacted the doctor and called me later to tell me the prescription would be filled.)

The doctor had to call the pharmacy personally for me to get this prescription. I wonder how the pharmacy knew he was a doctor and not just some clown on the phone. I could have called myself.

I mean, I’m not a real doctor but I play one in real life.