K-Hole Dreaming

I am in a new room. I am surrounded by new-to-me people. I am awake and flying. Everything I feel reaches what can only be described as elation. And I have no pain.

Not my hallucination, but AI's attempt.

I do an assessment of my body. I am in no pain. I expected surgery to make things worse, to set me back, to aggravate the body’s pain and then let me heal. Instead, nothing. The C-collar is still in place, but I can sit up, no longer in full spinal precautions. I can move. Any discomfort is more achy in nature than sharp or shooting. I cannot comprehend this and in all that is incomprehensible I am overjoyed.

And the walls. The walls are so white. It is as if the room is gleaming, a perpetual sparkle like in the Orbit gum commercials (https://www.youtube.com/shorts/LZU7ubxf-fI, in case it is helpful). The clock on the wall at the foot of my bed reads just after 0100. But the walls. It’s as if they are cartoonish, white ice cream in texture, slowly melting, and sparkling, but perfectly so, as if maintained at Disneyland for every customer’s repeated delight.

And the gratitude - I am alive - overwhelms. It’s as if it is tangible, palpable, mine to hold and cherish. It’s as though every gratitude list I’ve ever written, every gratitude I’ve have ever felt, is in my arms, mine to hold and cherish. But my gratitudes are too many to hold, they overflow my arms, unable to be contained, and so I start to cry. These are happy tears. I don’t even know why I am crying, but my tears feel like the only way to appropriately embrace and let out this overwhelming thankfulness.

It is so cliché, but I mutter something along the lines of, “I’m just so grateful to be alive.”

My nurse, Mack, calm and clear-eyed, says, “Oh, you’re on a ketamine drip. They left you on the ketamine after surgery and it will stay on for 24 hours.”

I am undeterred. There is no undermining or eroding this gratitude. K-hole or not, I am convinced that I am ordinarily this grateful in such situations, a situation I have never found myself in before in my life.

I remember the OR lights and I remember Sandy saying they are going to intubate me before they move me…and then…nothing. I went into surgery around 1000. It is now after 0100. I’ve lost 13 hours of my life and I don’t care. Surely I had to have visited PACU, but I have no recollection of anything. I am told that my pelvis is fixed. I am told that the noncommittal spine team fixed my neck while I was under. I am done. There is nothing left to do but recover, to heal, to eat.

The flying doesn’t stop. This is the most joy at 0100 I have felt in my life.

Ketamine’s anesthetic abilities are dissociative in nature, providing an alternate reality, hopefully one that is better and more delightful, as well as some pain control. I am here for all of it. Also, ketamine can cause some hallucinations, dark ones. Because of this, usually a benzodiazepine is a wonderful adjunct to go along with the ketamine, just to help you forget, just in case.

As a nurse, when I was in the float pool at Loma Linda University Medical Center, my patient had a wound dressing change scheduled. This was a deep, extensive wound, penetrating in and around this woman’s groin. Midazolam (the benzo) was given. Pain meds were given. And then the ketamine. Being from the ICU where everyone is sedated, we had no need for such bedside medications. Despite my ICU experience, I am the newbie today.

The ketamine hits and the doc starts the dressing change. This is a complex, deep wound. While the MD is removing the old dressing, this human starts yelling, “They’re raping me. They’re raping me.” We are not raping her, but the ketamine has sent her off. I am panicked. No one else seems to be. And this isn’t negligence. They’ve just seen this medication at work before, maybe even here, at her bedside. Her dark hallucinations are vivid and distressing to me alone, but with the midazolam on board, she won’t remember any of this reality or whatever she is experiencing in whatever realm she is. It will be as if she is happily asleep and will come back into herself with her wound dressing changed and clean and won’t know anything different. I may need therapy.

In the midst of my glaring pile of gratitudes, the memory of this woman and her dark hallucination comes back to me. I don’t want to close my eyes. I don’t want to feel anything other than this delight that is overwhelming me and painting the walls in gleaming white. Knowing that I am on ketamine and that my reality may be slightly enhanced, the tears dry themselves, but nothing can take away my joy and surprise knowing that my pelvis and spine are fixed and there is no more pain coursing through my body with the slightest of movements. The relief and gratitude remain unmatched.

Even now, in my state, I can only assume that my reality is so altered that when the ketamine is stopped, the pain will come for me. In this moment I don’t know how much the ketamine is doing for me and what it will be like when it is turned off. I make the decision to enjoy this flying for as long as I can. Tomorrow’s lack of ketamine will be a problem for tomorrow.

For now, all is light. I tentatively close my eyes and rest.