The Next Best Thing

In the morning, the high of the ketamine is less high. It’s as if the knowledge of being on ketamine allows my brain to account for it, slowing my highest highs and bringing them into a more palatable gratitude.This morning my cheeks are dry, the tears absent. The bathroom, its door, and the clock above it are all back to their unremarkable beige. All is well and near baselines although it’s impossible to know how my reality is being altered with the drip, drip, drip of ketamine entering my vein.

Today, Wednesday, Lindsey the PT comes to check on me and to make me move in ways I’m not sure I am able. She is slight in stature and frame, but it is her voice that belies her. She is feisty and sarcastic and somehow I can recognize this in her voice alone, her drawl, southern I’m assuming, is thick with some anticipated merriment. I am glad to be at her disposal.

My restrictions seem to be…restrictive. While everything of importance is fixed, my movements are untested and, therefore, unpredictable. Due to the the plate across the front of my pelvis and the screw to my right posterior pelvis, I am limited to non-weight-bearing status. Walking is off the table. As a concession, I am allowed to use my left leg for transfers. The right leg has to pretend it doesn’t know how to touch the ground. To make things a bit more tricky, I cannot use my right shoulder and subsequently the arm attached to it - they call it coffee cup restriction. I cannot use it to push and I cannot use to lift more than three pounds. Three pounds is a mere collection of feathers. Useless.

Lindsey walks me through what is expected - roll left,  pull my knees forward while simultaneously pushing up from my left side, drop the legs off the edge, and sit upright at the bedside. Easy peasy (eye roll). Today, she lets me cheat - the head of the bed is elevated slightly. I do as she says and manage to get to a sitting position. My right shoulder flails about. The raised head of bed saves me. This effort exhausts every bit of energy in my body. My head swims, but I stay upright. I breathe, an attempt to catch my breath, to deepen it, to be at rest in this position. It all feels out of reach.

This is my first time sitting since I drove myself to the trailhead on Saturday. It is now Wednesday. While I’ve succeeded at sitting up at bedside, the goal is to transfer to the wheelchair next to the bed. Although I am fatigued, my body is hungry for this work, at least this is what I tell myself. I want to complete this task. I must. I need to do something.

Lindsey stands in front of me. I rest my hospital-stockinged feet on the ground. This all feels distant, as if I’ve never touched the ground before. All that Lindsey is asking feels like a lot for post-op day one. While my brain is telling me to move, my body has seemed to have forgotten.

Lindsey places her left foot under my right, a reminder that I can’t use it. It is my left leg or nothing. I want to use my right arm, but she taps it gently. No deal. I push and pivot, left leg straining for all it is worth, leaning awkwardly, trying to balance my effort with my intention and what this body can actually do.

My bottom makes it into the wheelchair. Relief and satisfaction well up within me. I know what I just did and it is not a big deal, but, today, I will celebrate it.

Sitting up for the first time since surgery, I realize I don’t know what to do with my head. It feels so heavy, like it doesn’t belong here…or wherever it is. There is a burning in my spine, oddly perpendicular to its up/down direction. I can’t seem to find a position that allows my head to rest comfortably over my shoulders. I’m in the wheelchair but minutes and I beg to go back to bed, to lie down, to rest this bowling ball and get relief from this searing pain.

Lindsey is surprised by my pain, unsure of why it is so intense, especially because Jane pre-medicated me with methocarbamol and oxycodone before this activity. Those drugs aren’t touching this hot iron in my neck.

Back to bed I go. I cheat with my right foot. Lindsey calls me out. It feels like the only path forward is amputation for that right leg. My brain can’t seem to do this task without it.

I am relieved to be back in bed where my head is supported by something other than my spine. I hope this is temporary, something that time and practice might fix. For now, it just is what is.

I nap hard as if I just returned from a 30 mile run. Apparently, my body fatigues easily now. I am learning it as if a toddler coming into his body for the first time.

The Sweet Wife is here again along with her dad. They spend time quietly next to me. I am not a lot of fun, providing little to no engagement. They are very present even in my absence.

Kendra peels and feeds me oranges. For some reason the taste of each segment (Did you know a segment is officially called a carpel?) of orange in my mouth is the best flavor and I desire it more than anything else. I’m allowed to eat, of course, but my appetite is minimal to absent. It feels like an odd trick. Before surgery, I so desperately wanted to eat and I couldn’t. Now I can eat, but my desire to eat has vanished. I eat for flavor alone as I am perpetually satiated.

While Kendra is here and I am her primary work, Greg sits in the background. He doesn’t sit well and yet he is gracious and supportive. I almost feel guilty for his time here, sitting, but he does so patiently. In addition, he fulfills any need Kendra or I have whether it be blankets or condiments or ice. I cannot help but feel a sense of privilege to be apart of this family. Kendra is here to be sure I am okay and with her is the support of her entire family. I am lost in my gratitude.

The next day I have to poop. I hate pooping in the hospital. It is easily my least favorite activity. And because I’ve only transferred to the wheelchair and haven’t been cleared to the commode, I get the bedpan again. I have to believe it will be a bit easier because I’m not in full spinal precautions, thereby requiring less of a crowd, but I’m still not thrilled to have my poopy butt wiped by another human. Today, Sophie is doing the helping and the wiping. I feel for her. She seems indifferent to my abashment. This is just what she does.

It is indeed easier than my first time, but it is no less humiliating, despite one person needed instead of four. I am stuck in my consciousness as a capable human, a nurse, one who gives this care, not one who receives it. I think it would be fair to say that I am slow coming into my acceptance of this situation despite having my butt wiped again. Thanks, Sophie. There is no winning in this situation for my ego. There is nothing for me to do, but to receive the care that I need and just accept it. So. Much. Acceptance.

Cleo works on Harborview’s 7 East. I don’t know what she does or her title, but she is around. And she causes me quite a bit of merriment. The OT has me up in a different wheelchair, a Broda, and it reclines, allowing my bowling ball of a head to rest while I sit up. This combination feels like a concession, but I am sitting up. No one can take this from me.

Kendra and Greg take me out and about. This is the first time I can see where I am, instead of just the ceilings. After five days of ceilings, I’m pretty stoked to see walls and this hall and the unit I am on and the people just nonchalantly walking about. There is no way they know how good they have it.

There is a skybridge and we go there for the views. I am sitting up and the goal is to prolong this activity as long as possible. Please, I don’t want to go back to bed. I can see the street below. I can see the Sound in the distance. I can see the blue sky and I can feel the sunshine on my skin. This is happiness in a bottle. Being alive feels so simple here.

Cleo is here, too, just a few seats over on the skybridge. She comes over and has more stories. She comments on Jeff Bezos’s yacht arriving on the sound. “What if I’m your Make-A-Wish kid? Do you think we could get on his boat? I think we may have a chance.” She laughs at this and I’m delighted, yacht or not. I marvel at what makes the news. I’m not sure I understand any of it, or if it matters.

I am seated here, slightly reclined, my gown is covering all the important bits, and I’m wearing the pants that Lindsey offered/forced upon me to prevent the world from seeing my bruised groin. The hospital socks with their optimistically grippy pads complete the look. Cleo takes all this in and decides this isn’t good enough.

She talks as she works to release my brakes and then to sit me up a bit more, readying me to go somewhere else.. It’s during this that we find out she sings. She volunteers this information. Silly, Extrovert. I ask her for a song and, of course, she obliges. As a solid introvert, I don’t understand people like Cleo - I ask for a song, which seems far-fetched and she casually let’s it fly here on the skybridge. I don’t know the song, but it is gospel and holy. I feel underdressed for her concert. Her voice is deep and consuming. I don’t want this song to end. It does. Everything does. I still don’t know what she does here, but I’m quite pleased she is doing it.

She pushes me, with Kendra and Greg in tow, back to the 7E desk. She has a conversation with someone important and obtains permission for me to go to the 9th floor. Off we go for a short elevator ride and we’re back to the 9th floor, just a short hallway from the Trauma ICU where my stay at Harborview started.

Cleo’s efforts pay off. The views are better if only because I can see Mount Rainier. This view is healing in and of itself. Below and to my left, I am able to see the helicopter pad on which I arrived just days before. My brain doesn’t see this detail as significant. The events of the last few days feel far away, as if they area’t mine. Perhaps this is the definition of compartmentalization. Perhaps, more is coming, my brain set to remember more of the details that escape me now.. I have no fear or anxiety or worry. I see the world that I don’t seem to be apart of. Cleo leaves and we are left to sitting and taking it all in. The 9th floor is worth the trip.

__________

My nurse at night is Mack. She is quiet but so cool. I casually, and I’m certain, originally, call her Mack Attack. This nickname feels ironic because everything she does seems so intentionally kind.

Mack doesn’t mess around, yet I enjoy her every visit. I decide that if I had any ability to reincarnate myself, I would like to be her. Her confidence and presence feels comforting and a bit impressive. I know nothing about her, except that I like being around her. It’s as if I’m cool by association. I know none of this is true. She is worth noting, even here, as an odd appendage to my experiences on 7E. I can’t help but shout out Mack Attack, even though she kept the shenanigans to a minimum on night shift.

__________

Unlike the days before surgery, when I laid perfectly still in ICU, these days have beginnings and endings. I am next to the window. I watch the light arrive and then fade. There is about 20 minutes in the evening when I ask to have the shade pulled lower as the sun begins its descent to the horizon. This glow is glorious. If only these windows would open. I long to feel the breeze against my skin. I long to feel something different than scratchy blankets and recycled air. Let me smell the sea and the exhaust of the cars below. Let me hear the gulls. Let me gulp in the sea-laden air.

Saturday, even without its arrival, is already proving to be eventful. My foley removal is scheduled for 0600. I learn this the evening before, because Linda, my nurse tells me. A foley removal is normally not worth noting. I don’t need the twelve hours of notice I have been given. And yet, I don’t have much to look forward to in the hospital so a date and time for the removal of my urinary catheter feels riveting.

I sleep fitfully. My roommate has a traumatic brain injury (TBI) and is restless even in his sleep. He doesn’t know the time or where he is or why, and I imagine the darkness only makes things more confusing. He just knows that he wants to be somewhere else and that these tubes in his body should probably come out. And so he tries to remove the tubes in between whatever rest his body allows.

In addition to my roommate’s noises and movements, my body seems to be waking up at 0300, plus or minus. The pattern seems to be a 0300 wake-up and then two or so hours of ceiling staring before drifting in and out of whatever dawn naps are available. As with other mornings, this one is interrupted by blood draws and vital signs and the sounds of a hospital unit preparing for shift change.

Ordinarily I’d be quite perturbed, maybe even upset with my body, for its inability to stay asleep. And yet, my peace persists even now. In these dark, morning hours it occurs to me, naturally, as if I’ve always known the answer to this rhetorical questions: What do I matter? I have nowhere to be. There is no one waiting on my arrival or presence. This day’s schedule is wide open. I am existing in a state of complete lack of self importance. If I don’t sleep now, I’ll sleep later. Nothing matters. This thinking may eventually be problematic, but for now this feels like sanity, a gift of knowing where I exist in the world.

The light of the day finally rouses me and I am mostly awake minutes before 0600. The nurse doesn’t arrive and - Does it matter? - I spend my minutes looking out the window, watching the light paint the buildings around me. No matter what this day holds, I’m quite certain that my day will not get away from me.

At 0613, Meghan, my nurse for the night, arrives and she brings a friend. Her name is Emily. Meghan is here to pass meds - neurontin and tylenol if I remember correctly. Emily, a patient care tech (I think is the title), is here to remove my foley. Fun.

These ladies are both in their mid-twenties and I…am not. I feel elderly, as if I’m in a different world than both of these ladies, and, to some extent, I am. As is the theme with this hospital stay, regardless of our ages, I am at their mercy.

Meghan busies herself with the computer and passing meds. This is not high-level activity, merely tasks to be done. During the night, Meghan had come in, caring for my roommate, also her patient, and through the curtain, she says, “You snore.” There is no response to this. “Um, yeah? How would you like me to resolve my snoring so that your future nursing visits are more pleasant?” I don’t remember if I say this or if only think it. These children.

Meghan, who is now done passing meds, is logged out of the computer, and ready to leave. Change of shift is minutes away. It is inevitable that she has multiple other tasks to complete.

As a nurse, I know a foley removal should take about seven seconds. And yet, we are still here. Even after all our kibitzing, and med passing, the foley is still lodged in my bladder. Emily, oh sweet Emily, is holding the tube, “Where is all this urine coming from?” I know she knows and I know I know, but this question feels amazing. She continues to hold the tube, draining, draining, draining urine that we are not sure exactly where it is all coming from…but we do.

I’m not sure how I lose track of Emily, but when I see her again, she is wearing protective glasses. This is new. Again, as a nurse, a foley removal should not be so wild that protective eyewear is necessary. “How messy is this going to get?” My concern is skyrocketing.

And now, reader, if I could somehow describe to you both the delight and humiliation I am subjected to in this moment, this is that attempt.

We’re now at least 11 minutes in to a seven second procedure. Meghan, with her inevitable end-of-shift-to-do list has chosen to stay, thinking this is more entertaining than anything she has lined up for the next few minutes. She is doing nothing but standing next to the bed, watching, commenting.

I am supine - flat - and my gown is pulled up to my belly. The blanket that was covering me is now pulled down to my thighs. It’s as if a nest has been made around my penis and the foley catheter now with two ladies watching with a surprising nonchalance. Sweat is beading on my lower spine. Emily finally, graciously, has a syringe in hand. We are getting close. “Do you think this catheter is 5 mL or 10 mL?” She’s asking Meghan, I hope, because I don’t know.

“What? We’re not sure? For the love of all that is good, please just try for 10 mL, just in case.”

Emily obliges. She pulls the fluid out from the tip of the catheter, and then makes a second attempt. There is no more fluid. She tugs gently and the catheter slips from my bladder into the outside world. Surprisingly, no urine splashes on her protective glasses…or anywhere. Her preparation proved more scary than necessary.

Emily is still at work. With the foley in one hand, and a 4x4 gauze in the other, she gently reaches out with the 4x4 and boops the tip of my penis.

“Did you just…boop my penis?”

“Uh, yeah, it had a drop of pee on it.”

“Please never boop my penis again.” I have boundaries after all.

Emily, Meghan, and I are near tears, and likely all for different reasons. With the foley discarded, my penis nest returns to the proper layered assortment of gown and blanket. My back sweat persists despite their imminent departure. We are now 17 minutes in. I’m not sure why I am so fixated on the time with the abundance that I have, but this foley removal and its surprising duration had to have broken a record somewhere.

Emily and Meghan are going home for the day to sleep while I hang out with Linda and the PT and OT ladies. My Sweet Wife and my parents will be by for a visit today, and later, despite all the trappings of this morning’s foley removal, Emily and Meghan will be back and we will talk about big things, deep things, and this is my favorite - humans that are the both/and - and both of these ladies deliver.

I am here for all of it. I can’t move, so it makes it quite easy.

My parents, who had planned to arrive on Sunday, even prior to knowing of my accident, show up two days early to see my face in the hospital, to make sure that I am indeed alive. Now, on Saturday afternoon, the pie is brought out and I am ready for it. If there is anything that would guarantee my recovery it is this pie from a little pie shop in Salmon Arm, British Columbia. This is a raspberry rhubarb pie, my favorite and, likely anyone’s who has reasonable taste buds, from the Shuswap Pie Company. This is a treat of proportions I cannot describe.

My mom, ever prepared, has plates and forks and pie that is already pre-baked. I find out later they brought three more frozen pies for later. Their belief in my future thriving means a lot. And so we eat pie.

I ordered two vanilla ice creams with dinner and so this treat becomes à la mode. We invite over the father of my roommate who is siting, holding vigil for his son. We eat pie together and share the extra pieces with our nurses du jour. The pie is good. The togetherness is even better. It is good to be loved with pie.

Linda is my nurse today, again. She has a confidence that mixes well with her seeming indifference. She is diligent, but nothing is for show. She just does her work. Gold stars be damned.

And so it is now, after pie and relationship, that we start to think of discharge. Linda, as if dawning on her for the first time, realizes that this may be possible and starts her magic, messaging my pelvis and spine teams. It seems the limiting factor to my going home is a wheelchair, as in, we need to have one our possession. Lindsey ordered a wheelchair days ago but it has not yet arrived. One of our friends has offered us a wheelchair that they own and, most importantly, is in their possession. Kendra texts to see if we can use it, have it, and pick it up tomorrow morning. All the wheels are in motion. My discharge appears to be taking shape, coming together just as everything else seemed to do while I was within Harborview’s walls.

It all feels far-fetched, too good to be true, too early, perhaps? Linda gets all the thumbs ups. Nicole, my Saturday PT, gives her approval. All the hurdles have been cleared. I have benefitted from my time at Harborview. It is accurate to say, and not at all dramatic, that they saved my life. I have received care at the hands of kind and compassionate nurses and the capable doctors sewed and screwed and stitched me up. I am going to walk again because of their work. There is no way for me to overstate their work and my gratitude for it. But despite all the good that has taken place here, my anticipation to go home swells within me. It is all expectation and delight.

As with every discharge, there are so many questions - Will I be able to lie flat in bed? Will the wheelchair and me fit in a bathroom, allowing for my awkward transfers? Will I be able to tolerate sitting on any of our furniture pieces? There are more questions, but we will make it work, This is the path forward. There is no other way and so we will find our way through whatever it is that is coming. And by we, I mostly mean Kendra. Lucky her.

Sunday dawns and my anticipation builds. Kendra has secured the wheelchair and is bringing it with her to the hospital. Linda is working on my discharge paperwork. Jennifer, my ARNP from the ortho team, is filling out both my and Kendra’s FMLA paperwork. It feels as if everyone is leaning in, willing me to go home today, doing whatever it takes to save me (and my insurance) another $24,000 night’s stay. I am in all my gratitude, nearly as high and full as my arrival to this unit on ketamine.

Kendra arrives, wheelchair in her palms. Greg and JoLynne have come along for the spectacle and to help. It is a bit of a hurry-up-and-wait situation, but what else to do. I am at the mercy of this machine and the machine is machining.

By 1500, Linda is reading us the highlights of my discharge instructions. I put on a t-shirt and soft pants, all clothes that have no snaps. Linda pulls my last two IVs. Greg retrieves the car to meet us out front. Kendra splits off to pick up the medications I’ll need at home. JoLynne wheels me out into the glorious, warm sunshine. I breathe and breathe and breathe. I am in the throes of ecstasy. I will this moment to slow, to allow for my revelry. I am outside, but I am also…alive. After eight days at Harborview, I am well enough to go home. This all feels like a miracle, but I don’t understand miracles and I have no idea why I would deserve such a thing. All I know is that I am here and able to go there.

I transfer into the passenger seat of our Kia. The sunroof is open and the sun warms my sutured scalp. On any other day I would have shut the sunroof, the warmth too much. Today, I embrace all that is being offered. Kendra arrives with my medications and all the able-bodied humans load up. It is but a moment and we are off, we are driving, we are headed down James Street towards I-5 South and home.

It’s as if I’ve never been outside before. I am reclined, but elevated enough that I can see, that I can take in the world around us. The crowds and the congestion of the city might bother me on any regular day, but today is not regular. I am enamored by all of it.

When we hit traffic coming into Fife, others are understandably irritated. It is Sunday after all. To add to their irritation, I am delighted with all of it. My brain feels calm, quiet, imperturbable even in this slowdown.

The rest of the ride home is uneventful. We drop off the in-laws in Olympia so they can retrieve their car. They retrieve their car and groceries and follow us home. They are here to provide support, to ensure this transition from hospital to home is as smooth as possible.

And then, I am home and un-parceled from the car and I wheel myself from the garage into these walls that I know to be home. I feel my shoulders settle. My breathing slows, deepens. There is nothing left to do but be. I transfer into our recliner. The in-laws arrive. I eat grapes. The grapes’ flavor borders on irresistible. Strawberries and blueberries are placed next to me. I hear their voices and I drift off, my eyes unable to stay open for another second.

It is good to be home. Here, I can rest. Here I will heal. Here I will make my comeback for whatever days I have left.